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肝移植受者中两剂类固醇联合两剂达利珠单抗和他克莫司方案

[Two-dose steroid combined with two-dose daclizumab and tacrolimus regimen in liver transplant recipients].

作者信息

Ju Wei-qiang, He Xiao-shun, Tan Ya-li, Wu Lin-wei, Tai Qiang, Hu An-bin, Wang Dong-ping, Ma Yi, Zhu Xiao-feng, Huang Jie-fu

机构信息

Organ Transplantation Center, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2009 Jul 15;47(14):1064-6.

PMID:19781270
Abstract

OBJECTIVE

To investigate the efficiency and safety of two-dose steroid combined with two-dose daclizumab and tacrolimus (FK506) regimen in liver transplant recipients.

METHODS

There were 74 patients who treated in the First Affiliated Hospital of Sun Yat-Sen University from September 2006 to March 2008. Expect for 7 patients who didn't measure up, 67 adult liver transplant recipients were randomized into two groups: conventional protocol group (n = 35) in which steroid was withdrawn in 3 months after operation, and two-dose steroid group (n = 32). Comparison of rejection, infection (bacteria, fungal and cytomegalovirus) and metabolic complications rates were studied between two groups.

RESULTS

There were significant differences between two groups in the rate of early postoperation hyperglycemia, the average dosage of insulin consumption among hyperglycemia recipients as well as the rate of diabetes mellitus, hypertension and infection during the follow-up period (P < 0.05). The rate of hypertension in early postoperation period, hyperlipemia and rejection rate during the follow-up period were similar in two groups (P > 0.05).

CONCLUSIONS

Two-dose steroid combined with two-dose daclizumab and tacrolimus would be a safe and efficient immunosuppression strategy without increase the acute rejection rate hazard, that could reduce post-transplant infection and other complications from side-effect of long-term usage of steroid.

摘要

目的

探讨两剂类固醇联合两剂达利珠单抗和他克莫司(FK506)方案在肝移植受者中的有效性和安全性。

方法

2006年9月至2008年3月在中山大学附属第一医院接受治疗的患者有74例。除7例不符合条件的患者外,67例成年肝移植受者被随机分为两组:传统方案组(n = 35),术后3个月停用类固醇;两剂类固醇组(n = 32)。研究两组之间排斥反应、感染(细菌、真菌和巨细胞病毒)及代谢并发症发生率的比较。

结果

两组在术后早期高血糖发生率、高血糖受者胰岛素平均消耗量以及随访期间糖尿病、高血压和感染发生率方面存在显著差异(P < 0.05)。两组术后早期高血压发生率、随访期间高脂血症和排斥反应发生率相似(P > 0.05)。

结论

两剂类固醇联合两剂达利珠单抗和他克莫司是一种安全有效的免疫抑制策略,不会增加急性排斥反应发生率风险,且可减少移植后感染及长期使用类固醇副作用引起的其他并发症。

相似文献

1
[Two-dose steroid combined with two-dose daclizumab and tacrolimus regimen in liver transplant recipients].肝移植受者中两剂类固醇联合两剂达利珠单抗和他克莫司方案
Zhonghua Wai Ke Za Zhi. 2009 Jul 15;47(14):1064-6.
2
The use of an anti-CD25 monoclonal antibody and mycophenolate mofetil enables the use of a low-dose tacrolimus and early withdrawal of steroids in renal transplant recipients.使用抗CD25单克隆抗体和霉酚酸酯可使肾移植受者使用低剂量他克莫司并早期停用类固醇。
Clin Transplant. 2003 Jun;17(3):234-41. doi: 10.1034/j.1399-0012.2003.00038.x.
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Twenty-four hour steroid avoidance immunosuppressive regimen in liver transplant recipients.肝移植受者的24小时类固醇无激素免疫抑制方案
Exp Clin Transplant. 2012 Jun;10(3):258-62. doi: 10.6002/ect.2010.0127.
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Daclizumab induction and maintenance steroid-free immunosuppression with mycophenolate mofetil and tacrolimus to prevent acute rejection of hepatic allografts.使用霉酚酸酯和他克莫司进行达利珠单抗诱导及无类固醇维持免疫抑制以预防肝移植急性排斥反应。
Transpl Int. 2006 Aug;19(8):641-8. doi: 10.1111/j.1432-2277.2006.00326.x.
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Efficacy and cardiovascular safety of daclizumab, mycophenolate mofetil, tacrolimus, and early steroid withdrawal in renal transplant recipients: a multicenter, prospective, pilot trial.达利珠单抗、霉酚酸酯、他克莫司及早期停用类固醇对肾移植受者的疗效和心血管安全性:一项多中心、前瞻性、试点试验
Clin Transplant. 2005 Aug;19(4):475-82. doi: 10.1111/j.1399-0012.2005.00369.x.
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Corticosteroid-free immunosuppression with tacrolimus following induction with daclizumab: a large randomized clinical study.使用达利珠单抗诱导后用他克莫司进行无皮质类固醇免疫抑制:一项大型随机临床研究。
Liver Transpl. 2005 Jan;11(1):61-7. doi: 10.1002/lt.20307.
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Steroid elimination 24 hours after liver transplantation using daclizumab, tacrolimus, and mycophenolate mofetil.肝移植术后24小时使用达利珠单抗、他克莫司和霉酚酸酯时的类固醇消除情况。
Transplantation. 2001 Nov 27;72(10):1675-9. doi: 10.1097/00007890-200111270-00018.
8
A prospective randomized open study in liver transplant recipients: daclizumab, mycophenolate mofetil, and tacrolimus versus tacrolimus and steroids.肝移植受者的前瞻性随机开放研究:达克珠单抗、霉酚酸酯和他克莫司与他克莫司和类固醇。
Liver Transpl. 2009 Nov;15(11):1542-52. doi: 10.1002/lt.21854.
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Interleukin-2 receptor antibody (basiliximab) for immunosuppressive induction therapy after liver transplantation: a protocol with early elimination of steroids and reduction of tacrolimus dosage.白细胞介素-2受体抗体(巴利昔单抗)用于肝移植后免疫抑制诱导治疗:一项早期停用类固醇并减少他克莫司剂量的方案
Liver Transpl. 2004 Jun;10(6):728-33. doi: 10.1002/lt.20144.
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Promising early outcomes with a novel, complete steroid avoidance immunosuppression protocol in pediatric renal transplantation.一种新型的完全避免使用类固醇的免疫抑制方案在小儿肾移植中取得了有前景的早期疗效。
Transplantation. 2001 Jul 15;72(1):13-21. doi: 10.1097/00007890-200107150-00006.

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