诱导免疫抑制对囊性纤维化肺移植受者的生存获益。
Survival benefit of induction immunosuppression in cystic fibrosis lung transplant recipients.
机构信息
Department of Pediatrics, The Ohio State University, Columbus, OH, USA; Department of Internal Medicine, The Ohio State University, Columbus, OH, USA; Nationwide Children's Hospital, Columbus, OH, USA.
Department of Surgery, The Ohio State University, Columbus, OH, USA.
出版信息
J Cyst Fibros. 2015 Jan;14(1):104-10. doi: 10.1016/j.jcf.2014.05.010. Epub 2014 Jun 16.
BACKGROUND
Despite resistant microbes, induction immunosuppression is used in patients with cystic fibrosis (CF) undergoing lung transplantation (LTx).
METHODS
To evaluate the effect of induction immunosuppression on survival, the United Network for Organ Sharing (UNOS) was queried restricting analysis to transplant patients 6-55years old from 2001 to 2012, who received induction agents (INDUCED) or did not (NONE).
RESULTS
A total of 1721 CF patients who underwent LTx were included in the analysis; of these 791 (46%) were INDUCED. Of the INDUCED patients, 65% received basiliximab, 10% alemtuzumab, and 25% thymoglobulin/anti-lymphocyte globulin/anti-thymocyte globulin. Mean age was 28.0years (SD=9.7) and 28.5 (SD=9.5) for the INDUCED and NONE groups, respectively. The median survival in the INDUCED group was 93.8months (95% CI: 73.8, --) compared to 61.8months (95% CI: 55.8-73.8) for the NONE group (log rank p-value <0.001).
CONCLUSIONS
Antibody-based induction immunosuppression had a survival benefit in CF patients undergoing LTx.
背景
尽管存在耐药微生物，在接受肺移植（LTx）的囊性纤维化（CF）患者中仍使用诱导免疫抑制。
方法
为了评估诱导免疫抑制对生存的影响，查询了器官共享联合网络（UNOS），将分析限制在 2001 年至 2012 年接受诱导剂（INDUCED）或未接受诱导剂（NONE）的 6-55 岁移植患者。
结果
共纳入 1721 例接受 LTx 的 CF 患者进行分析；其中 791 例（46%）为 INDUCED。在接受诱导治疗的患者中，65%接受了巴利昔单抗，10%接受了阿仑单抗，25%接受了胸腺球蛋白/抗淋巴细胞球蛋白/抗胸腺细胞球蛋白。INDUCED 组的平均年龄为 28.0 岁（SD=9.7），NONE 组为 28.5 岁（SD=9.5）。INDUCED 组的中位生存时间为 93.8 个月（95%CI：73.8，--），而 NONE 组为 61.8 个月（95%CI：55.8-73.8）（对数秩检验 p 值<0.001）。
结论
在接受 LTx 的 CF 患者中，基于抗体的诱导免疫抑制具有生存获益。
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