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使用巴利昔单抗、他克莫司、霉酚酸酯和泼尼松进行四联免疫抑制治疗对肾移植是安全有效的。

Quadruple immunosuppression with basiliximab, tacrolimus, mycophenolate mofetil and prednisone is safe and effective for renal transplantation.

作者信息

Miura Masayoshi, Harada Hiroshi, Fukuzawa Nobuyuki, Iwami Daiki, Taniguchi Akihisa, Seki Toshimori, Togashi Masaki, Ogawa Yayoi, Satoh Hidetoshi, Hirano Tetsuo

机构信息

Department of Urology, Sapporo City General Hospital, Sapporo, Japan.

出版信息

Clin Transplant. 2005;19 Suppl 14:54-8. doi: 10.1111/j.1399-0012.2005.00393.x.

Abstract

INTRODUCTION

Recent immunosuppression with tacrolimus and mycophenolate mofetil has improved the results of renal transplantation. In this study, we analyzed the effect and safety of basiliximab as an induction therapy.

MATERIAL AND METHODS

Forty-nine kidney recipients were given tacrolimus, mycophenolate mofetil and prednisone (non-Bas group), and 31 recipients were given basiliximab as an induction therapy in addition to the triple immunosuppressants (Bas group). Graft function, incidence of acute rejection (AR), findings of protocol graft biopsy and adverse effects were compared.

RESULTS

Serum creatinine within 1 yr post-transplant was comparable between the two groups. Incidence of biopsy-proven AR within 6 months post-transplant was less in the Bas group than in the non-Bas group. Borderline change at 3 months post-transplant was less in the Bas group when compared to the non-Bas group. The frequency and severity of tubulitis were higher in the non-Bas group than in the Bas group. The addition of basiliximab did not increase opportunistic infection, but reduced tacrolimus nephrotoxicity.

CONCLUSION

The addition of basiliximab to the tacrolimus-based triple immunosuppressive regimen enabled us to reduce the doses of immunosuppressants and tacrolimus nephrotoxicity without increasing early rejection or infection. This regimen is safe and effective for application during the early period after renal transplantation.

摘要

引言

近期使用他克莫司和霉酚酸酯进行免疫抑制改善了肾移植的效果。在本研究中,我们分析了巴利昔单抗作为诱导治疗的效果和安全性。

材料与方法

49例肾移植受者接受他克莫司、霉酚酸酯和泼尼松治疗(非巴利昔单抗组),31例受者除接受三联免疫抑制剂治疗外还接受巴利昔单抗作为诱导治疗(巴利昔单抗组)。比较两组的移植肾功能、急性排斥反应(AR)发生率、移植肾活检结果及不良反应。

结果

两组移植后1年内的血清肌酐水平相当。移植后6个月内活检证实的AR发生率,巴利昔单抗组低于非巴利昔单抗组。与非巴利昔单抗组相比,巴利昔单抗组移植后3个月时的临界变化较少。非巴利昔单抗组肾小管炎的频率和严重程度高于巴利昔单抗组。添加巴利昔单抗并未增加机会性感染,但降低了他克莫司的肾毒性。

结论

在基于他克莫司的三联免疫抑制方案中添加巴利昔单抗,可使我们在不增加早期排斥反应或感染的情况下减少免疫抑制剂剂量和他克莫司肾毒性。该方案在肾移植术后早期应用安全有效。

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