Sheashaa Hussein A, Bakr Mohamed A, Fouda Mohamed Ashraf, El-Dahshan Khalid F, Ismail Amany M, Sobh Mohamed A, Ghoneim Mohamed A
Internal medicine and Nephrology, Urology & Nephrology Center, Mansoura University, 35516 Mansoura, Egypt.
Int Urol Nephrol. 2007;39(1):317-9. doi: 10.1007/s11255-006-9091-8. Epub 2007 Feb 27.
BACKGROUND/AIMS: The aim of this work is to determine the long-term therapeutic benefit(s) of daclizumab induction therapy with triple immunosuppressive protocols including prednisolone, cyclosporine microemulsion (CsA), and mycophenolate mofetil (MMF) in the living related donor kidney transplantation.
Twenty-one adult recipients of their first kidney allograft were allocated to receive daclizumab with triple immunosuppressive therapy (steroids, CsA, and MMF). They were compared to 50 recipients of their first grafts who received a maintenance triple immunosuppressive therapy (steroids, CsA, and azathioprine). The patients were followed up for 5 years.
Daclizumab group significantly experienced a marked reduction of acute rejection (7/21) when compared to the control group (31/50) with subsequent significant reduction of cumulative steroids doses at the end of 5 years. The overall incidence of post-transplant complications was comparable among the two treatment groups. There was no significant difference in patients and graft survival; 5-year patient and graft survival were 95.3%, 85.7% for daclizumab and 96%, 88% for control group, respectively.
Although prophylactic daclizumab with triple immunosuppressive protocol including MMF have drastically reduced the incidence of acute rejections, the graft and patient survival are unchanged in this long-term follow up.
背景/目的：本研究旨在确定在亲属活体肾移植中，使用包括泼尼松龙、环孢素微乳剂（CsA）和霉酚酸酯（MMF）的三联免疫抑制方案并联合达利珠单抗诱导治疗的长期疗效。
将21例首次接受肾移植的成年受者分配接受达利珠单抗联合三联免疫抑制治疗（类固醇、CsA和MMF）。将他们与50例首次接受移植且接受维持性三联免疫抑制治疗（类固醇、CsA和硫唑嘌呤）的受者进行比较。对患者进行了5年的随访。
与对照组（31/50）相比，达利珠单抗组急性排斥反应显著减少（7/21），且在5年末累积类固醇剂量显著降低。两个治疗组移植后并发症的总体发生率相当。患者和移植物存活率无显著差异；达利珠单抗组5年患者和移植物存活率分别为95.3%、85.7%，对照组分别为96%、88%。
尽管在包括MMF的三联免疫抑制方案中使用预防性达利珠单抗可大幅降低急性排斥反应的发生率，但在本次长期随访中，移植物和患者存活率未发生变化。
