他克莫司在高危角膜移植中的免疫抑制作用。
Tacrolimus immunosuppression in high-risk corneal grafts.
作者信息
Joseph A, Raj D, Shanmuganathan V, Powell R J, Dua H S
机构信息
Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, UK.
出版信息
Br J Ophthalmol. 2007 Jan;91(1):51-5. doi: 10.1136/bjo.2006.097428. Epub 2006 Sep 6.
BACKGROUND
Unlike the immune privilege enjoyed by low-risk corneal grafts, high-risk corneal grafts experience rejection rates comparable to liver and kidney transplants. Systemic immunosuppression reduces the risk of rejection in high-risk corneal grafts.
METHODS
Systemic tacrolimus, a specific T cell inhibitor, was used at a mean daily dose of 2.5 mg to immunosuppress 43 patients undergoing high-risk corneal transplantation. Immunosuppression was continued for a period of 18-24 months after the high-risk corneal graft.
RESULTS
During a mean follow-up period of 33.7 months, clarity of the graft was maintained in 65% of patients. Eight patients experienced rejection episodes while on tacrolimus, and this led to graft failure in five patients.
CONCLUSION
Tacrolimus is relatively safe and effective in reducing rejection and prolonging graft survival in patients with high-risk keratoplasty compared with other series where similar immunosuppression was not used.
背景
与低风险角膜移植所具有的免疫赦免不同，高风险角膜移植的排斥率与肝移植和肾移植相当。全身免疫抑制可降低高风险角膜移植的排斥风险。
方法
使用特异性T细胞抑制剂他克莫司进行全身给药，平均日剂量为2.5mg，对43例接受高风险角膜移植的患者进行免疫抑制。在高风险角膜移植后，免疫抑制持续18 - 24个月。
结果
在平均33.7个月的随访期内，65%的患者移植片保持透明。8例患者在使用他克莫司期间发生排斥反应，其中5例导致移植失败。
结论
与未使用类似免疫抑制的其他系列研究相比，他克莫司在降低高风险角膜移植患者的排斥反应和延长移植片存活方面相对安全有效。
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