MacDonald A S, Belitsky P, Bitter-Suermann H, Cohen A
Transplant Service, Dalhousie University, Victoria General Hospital, Halifax, Nova Scotia, Canada.
Transplant Proc. 1989 Feb;21(1 Pt 2):1667-9.
Between 1981-87, 48 HLA identical sibling graft recipients were allocated to one of three treatment groups: Group I-15 patients Aza and Pred; Group II-12 CyA alone; Group III-21 CyA and steroids. Only one patient died from a fatal hereditary disease. Graft survival was 100% at one year in all groups and at three years was 86% for Aza, 94% for CyA alone and 100% for CyA and steroids. Rejection episodes occurred in 50% of Aza patients versus 18% in the CyA groups. However 55% of CyA patients require anti-hypertensives versus 20% of Aza recipients, and 12% of CyA patients were switched because of drug toxicity. In a previous study of 36 Aza treated A-matched patients, five of eight losses occurred after the first 5 years--most related to long term effects of immunosuppression. We may have to wait for longer follow-up before drawing conclusions regarding the use of CyA in identically matched living related recipients.
在1981年至1987年期间，48名HLA相同的同胞移植受者被分配到三个治疗组之一：第一组——15名患者使用硫唑嘌呤（Aza）和泼尼松（Pred）；第二组——12名患者仅使用环孢素（CyA）；第三组——21名患者使用环孢素和类固醇。只有一名患者死于一种致命的遗传性疾病。所有组在一年时的移植存活率均为100%，在三年时，使用硫唑嘌呤的患者为86%，仅使用环孢素的患者为94%，使用环孢素和类固醇的患者为100%。50%使用硫唑嘌呤的患者发生排斥反应，而环孢素组为18%。然而，55%使用环孢素的患者需要使用抗高血压药物，而使用硫唑嘌呤的受者为20%，并且12%使用环孢素的患者因药物毒性而换药。在之前一项对36名使用硫唑嘌呤治疗的A配型患者的研究中，8例移植失败中有5例发生在最初5年后——大多数与免疫抑制的长期影响有关。在得出关于在HLA相同的活体亲属受者中使用环孢素的结论之前，我们可能需要更长时间的随访。
