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肾移植受者单剂量达克珠单抗诱导方案:中国单中心经验

A single-dose daclizumab induction protocol in renal allograft recipients: a Chinese single center experience.

作者信息

Ji S-M, Li L-S, Cheng Z, Cheng D-R, Sun Q-Q, Chen J-S, Sha G-Z, Liu Z-H

机构信息

Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhong Shan Road, Nanjing 210002, China.

出版信息

Transplant Proc. 2007 Jun;39(5):1396-401. doi: 10.1016/j.transproceed.2006.11.016.

Abstract

This study prospectively compared immunoprophylaxis with a single dose of daclizumab versus no induction in kidney transplant recipients treated with a cyclosporine, mycophenolate mofetil, and prednisone-based immunosuppression regimen seeking to observe the impact of a single-dose regimen for prevention of acute rejection among Chinese renal allograft recipients. A total of 118 renal transplant recipients were randomized into a daclizumab induction therapy group (daclizumab group, n = 58) and a no induction group (control group, n = 60). The daclizumab group received a single-dose (1 mg/kg of ideal body weight by intravenous infusion) 2 hours before the operation. There was no induction therapy in the control group. There was no significant difference in the baseline parameters at randomization between the two groups. The mean time to the first episode of acute rejection was 41.2 +/- 3.2 days for the daclizumab group versus 11.2 +/- 4.6 days for the control group. The number of first biopsy-confirmed acute rejection episodes during the 6-months after transplantation was significantly different in the daclizumab (7,12.1%) versus the control group (14,23.3%; P < .001). At the end of 12 months, patient and graft survivals were 100% in the groups with or without daclizumab. We noted that the incidence of infection, including serious infection was similar, in the daclizumab group to that in the control group, 17.2% and 20.0%, respectively. This study showed that a single-dose of daclizumab effectively prevented acute rejection in Chinese renal allograft recipients.

摘要

本研究前瞻性地比较了在接受环孢素、霉酚酸酯和泼尼松为基础的免疫抑制方案治疗的肾移植受者中,单剂量达利珠单抗免疫预防与不进行诱导治疗的效果,旨在观察单剂量方案对中国肾移植受者预防急性排斥反应的影响。总共118例肾移植受者被随机分为达利珠单抗诱导治疗组(达利珠单抗组,n = 58)和无诱导治疗组(对照组,n = 60)。达利珠单抗组在手术前2小时接受单剂量(按理想体重1 mg/kg静脉输注)治疗。对照组不进行诱导治疗。两组随机分组时的基线参数无显著差异。达利珠单抗组首次急性排斥反应发作的平均时间为41.2±3.2天,而对照组为11.2±4.6天。移植后6个月内首次经活检证实的急性排斥反应发作次数在达利珠单抗组(7例,12.1%)与对照组(14例,23.3%;P <.001)之间有显著差异。在12个月结束时,使用或未使用达利珠单抗的组中患者和移植物存活率均为100%。我们注意到,达利珠单抗组与对照组的感染发生率(包括严重感染)相似,分别为17.2%和20.0%。本研究表明,单剂量达利珠单抗可有效预防中国肾移植受者的急性排斥反应。

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