Naini Afsoon Emami, Harandi Ali Amini, Daemi Pooya, Kosari Rozbeh, Gharavi Manochehr
Department of Nephrology, Khorshid Hospital, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.
Saudi J Kidney Dis Transpl. 2008 Jan;19(1):59-61.
Continuation of low-dose maintenance immunosuppressive therapy in end-stage renal allografts (ESRAs) that are left in situ is controversial. We studied the outcome of 85 patients (mean age 33.3 +/- 13.4 and range of 12-56 years) on hemodialysis with ESRAs, and without immunosuppressive therapy in our center from July 1991 to July 2003. Twelve (14.1%) study patients underwent allograft nephrectomy within a mean interval of 44.5 months after graft failure. The rest of the patients remained stable without fever, hematuria, graft tenderness, or localized edema during a mean interval of 46.5 +/- 45.2 months of follow-up. These results are promising and suggest that maintenance immuno-suppressive therapy in patients with ESRAs and on dialysis may not be necessary to avoid allograft nephrectomy. Prospective studies are warranted to substantiate these results.
对于原位保留的终末期同种异体肾移植（ESRA）患者，继续进行低剂量维持性免疫抑制治疗存在争议。我们研究了1991年7月至2003年7月期间在本中心接受血液透析的85例ESRA患者（平均年龄33.3±13.4岁，年龄范围12 - 56岁），这些患者未接受免疫抑制治疗。12例（14.1%）研究患者在移植失败后的平均44.5个月内接受了移植肾切除术。其余患者在平均46.5±45.2个月的随访期间保持稳定，无发热、血尿、移植肾压痛或局部水肿。这些结果很有前景，表明对于接受透析的ESRA患者，为避免移植肾切除术，维持免疫抑制治疗可能并非必要。有必要进行前瞻性研究以证实这些结果。
