Nevins Thomas E, Matas Arthur J
Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
Transplantation. 2004 Mar 15;77(5):776-8. doi: 10.1097/01.tp.0000110409.71847.6f.
After renal transplantation, immunosuppressive medications must be taken long-term to avoid acute rejection and the cascade of events leading to "chronic allograft dysfunction" and loss. In the past, when posttransplant immunosuppression was limited to azathioprine and prednisone, acute rejection episodes were common, and it was difficult to identify the impact of medication noncompliance. However, with more potent and effective drugs, acute rejection is uncommon, and medication noncompliance emerges as an increasingly important factor in the outcome of solid-organ transplantation. Recent studies have clearly demonstrated that medication noncompliance leads to an increased incidence of acute rejection, chronic rejection, and graft loss. Today, although a number of questions remain unanswered, new methodologies, such as electronic monitors, provide opportunities to study medication noncompliance and its risk factors, and the potential for earlier intervention to improve clinical outcomes.
肾移植后，必须长期服用免疫抑制药物，以避免急性排斥反应以及导致“慢性移植肾功能不全”和移植肾丧失的一系列事件。过去，当移植后的免疫抑制仅限于硫唑嘌呤和泼尼松时，急性排斥反应很常见，而且很难确定药物不依从的影响。然而，随着更有效力和更有效的药物出现，急性排斥反应已不常见，而药物不依从成为实体器官移植结果中一个日益重要的因素。最近的研究清楚地表明，药物不依从会导致急性排斥反应、慢性排斥反应和移植肾丧失的发生率增加。如今，尽管仍有许多问题未得到解答，但新的方法，如电子监测器，为研究药物不依从及其危险因素以及早期干预以改善临床结果提供了机会。
