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
Organ Transplantation Center, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China.
Zhonghua Wai Ke Za Zhi. 2009 Jul 15;47(14):1064-6.
To investigate the efficiency and safety of two-dose steroid combined with two-dose daclizumab and tacrolimus (FK506) regimen in liver transplant recipients.
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liver transplant recipients were randomized into two groups: conventional protocol group (n = 35) in which steroid was withdrawn in 3 months after operation, and two-dose steroid group (n = 32).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.
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).
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.
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。
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。
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)。
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。