Halleck F, Friedersdorff F, Fuller T F, Matz M, Huber L, Dürr M, Schütz M, Budde K
Department of Nephrology, Charité Universitätsmedizin Berlin, Germany.
Transplant Proc. 2013 Apr;45(3):1224-31. doi: 10.1016/j.transproceed.2013.02.033.
Efficient rejection prophylaxis and excellent short-term results in organ transplantation can not obscure the fact that long-term outcomes have not improved substantially over the last decade with rather constant graft attrition rates beyond the first year. There remains an unmet medical need for new immunosuppressive regimens to improve long-term graft and patient survival while carrying a low side effect burden. Several trials in renal transplant recipients are in the planning stages. In general there are two major strategies to improve outcomes: (a) the constant evolution of new immunosuppressive regimens with the currently approved immunosuppressants, and/or (b) the use of novel immunosuppressants. In this review, we give an overview of the most recent developments of novel immunosuppressive regimes. We show promising new immunosuppressive drugs and new immunosuppressive strategies serving as potential alternative's for calcineurin inhibitor-based regimens. Such regimens should provide similar efficacy and eventually better tolerability or a different side-effect profile with clinical benefits.
在过去十年中，长期结果并未显著改善，第一年之后的移植物损耗率相当稳定。对于新的免疫抑制方案仍存在未满足的医疗需求，以提高长期移植物和患者的存活率，同时降低副作用负担。多项针对肾移植受者的试验正处于规划阶段。总体而言，有两种主要策略来改善结果：（a）使用目前已获批的免疫抑制剂不断改进新的免疫抑制方案，和/或（b）使用新型免疫抑制剂。在本综述中，我们概述了新型免疫抑制方案的最新进展。我们展示了有前景的新型免疫抑制药物和新的免疫抑制策略，它们可作为基于钙调神经磷酸酶抑制剂方案的潜在替代方案。此类方案应具有相似的疗效，并最终具有更好的耐受性或不同的副作用特征以及临床益处。
