Starzl T E, Todo S, Fung J, Demetris A J, Venkataramman R, Jain A
Department of Surgery, University Health Center of Pittsburgh, Pennsylvania.
Lancet. 1989 Oct 28;2(8670):1000-4. doi: 10.1016/s0140-6736(89)91014-3.
FK 506 was given for immunosuppression in 14 liver recipients. The drug was used in the first 10 cases because the recipients under conventional immunosuppression had rejection, nephrotoxicity, or both. This salvage therapy was successful in 7 of the 10 attempts. 2 of the 10 patients in the original salvage group as well as 4 new patients underwent fresh orthotopic liver transplantation under FK 506 plus low-dose steroids from the outset. None of these 6 patients had rejection although 1 with preexisting cor pulmonale and coronary atherosclerosis died of a myocardial infarction. In addition, 2 of the 14 liver recipients were given cadaveric kidneys, either from the same donor or from a different donor, and a third was given a pancreas as well as a kidney from the liver donor. There were no rejections of the kidney and pancreas grafts, and serious side-effects were not encountered.
14例肝移植受者接受FK 506免疫抑制治疗。在前10例患者中使用该药物是因为接受传统免疫抑制治疗的受者出现了排斥反应、肾毒性或两者皆有。这种挽救治疗在10次尝试中有7次成功。最初挽救治疗组的10例患者中有2例以及4例新患者一开始就接受了FK 506加小剂量类固醇的原位肝移植。这6例患者均未发生排斥反应,尽管1例有慢性肺心病和冠状动脉粥样硬化的患者死于心肌梗死。此外,14例肝移植受者中有2例接受了来自同一供者或不同供者的尸体肾移植,第3例还接受了来自肝供者的胰腺和肾移植。肾和胰腺移植物均未发生排斥反应,也未出现严重的副作用。