Beimler J, Morath C, Zeier M
Sektion Nephrologie, Nierenzentrum Heidelberg, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 162, 69120, Heidelberg, Deutschland,
Internist (Berl). 2014 Feb;55(2):212-22. doi: 10.1007/s00108-013-3411-8.
The one common factor in solid organ transplantation is the need for lifelong maintenance immunosuppression. Drug regimens after organ transplantation typically comprise a combination of different immunosuppressive drugs. In most cases a triple drug regimen with different mechanisms of action is used. The aim is to improve both patient and graft survival while minimizing potential side effects of immunosuppressive medication. The basis of most immunosuppressive regimens is calcineurin inhibitors in combination with mycophenolic acid. There are various stages of immunosuppression after solid organ transplantation involving induction therapy, initial and long-term maintenance therapy. In each phase an individual combination of immunosuppressants is set up depending on the risk profile of the individual patient to prevent transplant rejection and organ loss. Based on these considerations, concepts of calcineurin inhibitor or steroid reduction have been established in transplant medicine in recent years. The key role in terms of development of new immunosuppressive strategies is taken by kidney transplantation, the most common solid organ transplantation performed.
实体器官移植的一个共同因素是需要终身维持免疫抑制。器官移植后的药物治疗方案通常包括不同免疫抑制药物的联合使用。在大多数情况下，会使用具有不同作用机制的三联药物治疗方案。目的是提高患者和移植物的存活率，同时将免疫抑制药物的潜在副作用降至最低。大多数免疫抑制方案的基础是钙调神经磷酸酶抑制剂与霉酚酸联合使用。实体器官移植后的免疫抑制有不同阶段，包括诱导治疗、初始和长期维持治疗。在每个阶段，根据个体患者的风险状况制定个体化的免疫抑制剂组合，以防止移植排斥和器官丧失。基于这些考虑，近年来移植医学中已经确立了减少钙调神经磷酸酶抑制剂或类固醇的概念。在新免疫抑制策略的发展方面，肾移植发挥着关键作用，肾移植是最常见的实体器官移植。
