以他克莫司为基础的免疫抑制方案联合巴利昔单抗、霉酚酸酯和低剂量类固醇可降低肾移植中的急性排斥反应。
Regimen of tacrolimus-based immunosuppression with basiliximab, mycophenolate mofetil, and low-dose steroid reduces acute rejection in kidney transplants.
作者信息
Hoshinaga K, Aikawa A, Murai M, Yamamoto H, Hirayama N, Shishido S, Hasegawa A
机构信息
Department of Urology, Fujita Health University, Toyoake, Aichi, Japan.
出版信息
Transplant Proc. 2005 May;37(4):1762-3. doi: 10.1016/j.transproceed.2005.02.066.
BACKGROUND
Acute rejection is a major problem in kidney transplantation. To reduce its likelihood, we investigated the efficacy and safety of an immunosuppressive regimen including tacrolimus, basiliximab, mycophenolate mofetil, and low-dose steroids.
METHODS
Fifty-seven patients, including 14 pediatric patients, were enrolled in this study. The mean age at the time of transplantation was 33.5 years, and the mean observation period was 8.2 months. The mean trough concentrations of FK at 1, 6, and 12 months posttransplant were 10.2, 6.6, and 6.0 ng/mL, respectively.
RESULTS
All recipients survived without graft loss. The cumulative incidence of acute rejection in adults was 2.3% and 8.4% at 6 and 12 months posttransplant, respectively. Of the adverse events, 11 recipients (19.3%) were positive for CMV antigenemia or had CMV infections. Four recipients (7.0%) exhibited mild hyperglycemia.
CONCLUSIONS
Our immunosuppressive regimen demonstrated favorable results, reducing the incidence of acute rejection without causing severe adverse events, especially in adults.
背景
急性排斥反应是肾移植中的一个主要问题。为降低其发生可能性，我们研究了一种免疫抑制方案的疗效和安全性，该方案包括他克莫司、巴利昔单抗、霉酚酸酯和低剂量类固醇。
方法
本研究纳入了57例患者，其中包括14例儿科患者。移植时的平均年龄为33.5岁，平均观察期为8.2个月。移植后1、6和12个月时FK的平均谷浓度分别为10.2、6.6和6.0 ng/mL。
结果
所有受者均存活，无移植物丢失。成人移植后6个月和12个月时急性排斥反应的累积发生率分别为2.3%和8.4%。在不良事件中，11例受者（19.3%）CMV抗原血症呈阳性或发生了CMV感染。4例受者（7.0%）出现轻度高血糖。
结论
我们的免疫抑制方案显示出良好的效果，降低了急性排斥反应的发生率，且未引起严重不良事件，尤其是在成人中。
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