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[抗淋巴细胞血清与硫唑嘌呤,联合环孢素和类固醇,用于肝移植。重症监护病房结果与2年随访的比较]

[Antilymphocytic sera versus azathioprine, combined with cyclosporin and steroids, in liver transplant. Comparison of the results at the intensive care unit and 2 years' follow-up].

作者信息

Cisneros Alonso C, Díaz Castellanos M A, Montero Castilló A, Moreno González E, Calleja González J, Gómez Gutiérrez M, Sánchez-Izquierdo Riera J A, García Fuentes C

机构信息

Departmento de Medicina Intensiva, Hospital 12 de Octubre, Universidad Complutense, Madrid.

出版信息

Rev Clin Esp. 1990 Feb;186(2):68-73.

PMID:2330440
Abstract

The use of anti-lymphocyte globulins (ATG, ALG, OKT3) for the control or organ rejection in humans, has been of major importance both in preventing and treating organ rejection resistant to other treatments. We present here the results of our immunosuppression protocol using two different therapeutic associations. To the first group consisting of 29 patients, low doses of cyclosporine, steroids and anti-lymphocyte globulins were given, and to another group of 11 patients azathioprine was given together with cyclosporine and steroids at the same doses as in the first group. We want to point out that the incidence of acute rejections was similar in both groups (17.2% vs 18.1%) immediately after surgery and a greater incidence of rejections at a later time during the follow up period in the group treated with azathioprine (34.4% vs 54.6%). The incidence of chronic rejections was similar in both groups (10.3% vs 8.9%). During the follow up period, the incidence of infections was higher in the group treated with azathioprine (13.7% vs 36.4%) as well as bacteremia episodes (17.2% vs 45.4%) (p less than 0.1). We also want to highlight that patients with graft complications (primary graft rejection) suffered infections (p less than 0,001) and had a higher mortality rate (p less than 0,05) in association to the infection.

摘要

使用抗淋巴细胞球蛋白(抗胸腺细胞球蛋白、抗淋巴细胞球蛋白、OKT3)来控制人体器官排斥反应,在预防和治疗对其他治疗有抵抗性的器官排斥反应方面都具有重要意义。我们在此展示了使用两种不同治疗组合的免疫抑制方案的结果。对于第一组29名患者,给予低剂量的环孢素、类固醇和抗淋巴细胞球蛋白,而对于另一组11名患者,给予与第一组相同剂量的硫唑嘌呤,同时给予环孢素和类固醇。我们想指出,两组术后立即发生急性排斥反应的发生率相似(分别为17.2%和18.1%),但在随访期间,接受硫唑嘌呤治疗的组后期排斥反应发生率更高(分别为34.4%和54.6%)。两组慢性排斥反应的发生率相似(分别为10.3%和8.9%)。在随访期间,接受硫唑嘌呤治疗的组感染发生率更高(分别为13.7%和36.4%),菌血症发作率也更高(分别为17.2%和45.4%)(p小于0.1)。我们还想强调,有移植物并发症(原发性移植物排斥反应)的患者发生感染(p小于0.001),且与感染相关的死亡率更高(p小于0.05)。

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