Gaston Robert S
Division of Nephrology, University of Alabama, School of Medicine, Birmingham, AL, USA.
Am J Kidney Dis. 2006 Apr;47(4 Suppl 2):S3-21. doi: 10.1053/j.ajkd.2005.12.047.
The advent of novel immunosuppressive agents with increased potency now offers multiple treatment options for transplant physicians. However, variable efficacy, drug-drug interactions, and adverse effects associated with long-term immunosuppression continue to complicate the clinical management of kidney transplant recipients. Currently, investigators are challenged to develop regimens that take into account not only efficacy, but also dosing, monitoring, safety, and patient quality of life. Recent research has focused on evaluating new combinations of approved agents that seek to improve outcomes by improving control of immunologic events with fewer complications. This article reviews current practice and recent studies to give all health care providers who manage kidney transplant recipients a better understanding of current regimens and general trends in immunosuppressive therapy.
新型强效免疫抑制剂的出现,为移植医生提供了多种治疗选择。然而,免疫抑制效力的差异、药物相互作用以及与长期免疫抑制相关的不良反应,仍使肾移植受者的临床管理复杂化。目前,研究人员面临的挑战是制定不仅要考虑疗效,还要兼顾给药、监测、安全性和患者生活质量的治疗方案。近期的研究集中在评估已获批准药物的新组合,旨在通过更好地控制免疫反应、减少并发症来改善治疗效果。本文回顾了当前的实践和最新研究,以便让所有负责管理肾移植受者的医护人员更好地了解当前的治疗方案以及免疫抑制治疗的总体趋势。