Peruzzi Licia, Amore Alessandro, Coppo Rosanna
Licia Peruzzi, Alessandro Amore, Rosanna Coppo, University-Hospital Health Agency Città della Salute e della Scienza di Torino, Nephrology, Dialysis and Transplantation Unit, Regina Margherita University Children's Hospital, 10126 Turin, Italy.
World J Transplant. 2014 Dec 24;4(4):222-8. doi: 10.5500/wjt.v4.i4.222.
Transplantation in children is the best option to treat renal failure. Over the last 25 years the improvements in therapy have dramatically reduced the risk of early acute rejection and graft loss, however the long term results in terms of graft survival and morbidity still require search for new immunosuppressive regimens. Tolerance of the graft and minimization of side effects are the challenges for improving the outcome of children with a grafted kidney. Notwithstanding the difficulties in settling in children large multicenter trials to derive statistically useful data, many important contributions in the last years brought important modifications in the immunosuppressive therapy, including minimization protocols of steroids and calcineurin inhibitors and new induction drugs. New methods for diagnosis of anti HLA antibodies and some new protocols to improve both chance and outcome of transplantation in immunized subjects represent area of ongoing research of extreme interest for children.
儿童肾移植是治疗肾衰竭的最佳选择。在过去25年中，治疗方法的改进显著降低了早期急性排斥反应和移植肾丢失的风险，然而，就移植肾存活和发病率而言，长期结果仍需要寻找新的免疫抑制方案。移植肾的耐受性和副作用的最小化是改善肾移植儿童预后的挑战。尽管在儿童中开展大型多中心试验以获得具有统计学意义的有用数据存在困难，但近年来的许多重要进展给免疫抑制治疗带来了重要改变，包括类固醇和钙调神经磷酸酶抑制剂的最小化方案以及新的诱导药物。抗HLA抗体的新诊断方法以及一些改善免疫致敏受者移植机会和预后的新方案，是目前儿童研究中极具吸引力的领域。
