Campistol J M
Nephrology Department, Hospital Clinic, Barcelona, Spain.
Transplant Proc. 2010 Nov;42(9 Suppl):S47-8. doi: 10.1016/j.transproceed.2010.09.016.
Despite the progressive improvement in the early outcomes of renal transplantation, longer-term outcomes such as graft and patient survival have changed little since the introduction of cyclosporine-based immunosuppression. The major causes of graft loss after the first year are, first, chronic allograft nephropathy (CAN), and, second, death with a functioning graft. Kidney transplant recipients are not a homogenous population and so careful consideration is needed to individualize care in order to reduce the risk of cardiovascular disease and malignancy and improve long-term outcomes. A key component will be the consideration of the early and late phases of immunosuppression and the modification of immunosuppression in order to address the specific short- and long-term risks faced by each of our kidney transplant patients. The insights presented and discussed at this symposium will help to inform the design of new clinical strategies that may hold potential for improving the quality and quantity of life of the wide range of patients that we manage on a daily basis.
尽管肾移植早期结果有逐步改善，但自引入以环孢素为基础的免疫抑制治疗以来，移植物和患者生存等长期结果变化不大。术后第一年移植物丢失的主要原因，一是慢性移植肾肾病（CAN），二是移植物功能良好时的死亡。肾移植受者并非同质化群体，因此需要仔细考虑个体化护理，以降低心血管疾病和恶性肿瘤风险并改善长期结果。一个关键因素将是考虑免疫抑制的早期和晚期阶段以及调整免疫抑制方案，以应对我们每位肾移植患者面临的特定短期和长期风险。本次研讨会展示和讨论的见解将有助于为新临床策略的设计提供信息，这些策略可能有潜力改善我们日常管理的广大患者的生活质量和寿命。
