Schmitt Wilhelm H, van der Woude Fokko J
Vth Medical Clinic (Nephrology, Endocrinology), University-Clinic Mannheim, Faculty of Clinical Medicine of The University of Heidelberg, Germany.
Curr Opin Rheumatol. 2003 Jan;15(1):22-8. doi: 10.1097/00002281-200301000-00005.
Despite important therapeutic improvements, permanent organ failure may develop in primary systemic vasculitides and affect the heart, the lungs, and especially the kidneys. In systemic vasculitides associated with antineutrophil cytoplasmic antibodies (AASV), end-stage renal failure develops in 20% of cases. Renal transplantation became a beneficial option in these patients, with a graft and patient survival comparable to that in nondiabetic patients. This review summarizes the current knowledge on indications and contraindications for renal transplantation in AASV and discusses the impact of posttransplant immunosuppression on the course of the patients.
尽管在治疗方面取得了重要进展,但原发性系统性血管炎仍可能发展为永久性器官衰竭,并累及心脏、肺,尤其是肾脏。在抗中性粒细胞胞浆抗体相关性系统性血管炎(AASV)中,20%的病例会发展为终末期肾衰竭。肾移植已成为这些患者的有益选择,其移植物和患者生存率与非糖尿病患者相当。本文综述了目前关于AASV患者肾移植适应证和禁忌证的知识,并讨论了移植后免疫抑制对患者病程的影响。