稳定的ABO血型不相容肾移植受者从霉酚酸酯转换为依维莫司的初步转换研究：1年随访数据分析
Pilot Conversion Study From Mycophenolate Mofetil to Everolimus in Stable ABO-Incompatible Kidney Transplant Recipients: Analysis of 1-Year Follow-Up Data.
作者信息
Uchida Junji, Iwai Tomoaki, Nishide Shunji, Kabei Kazuya, Kuwabara Nobuyuki, Naganuma Toshihide, Kumada Norihiko, Takemoto Yoshiaki, Nakatani Tatsuya
机构信息
From the Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
Exp Clin Transplant. 2019 Apr;17(2):190-195. doi: 10.6002/ect.2017.0200. Epub 2018 Sep 4.
OBJECTIVES
Here, we report our 1-year follow-up data of stable ABO-incompatible kidney transplant recipients who converted from mycophenolate mofetil plus a standard dose of a calcineurin inhibitor to everolimus plus low exposure to calcineurin inhibitors.
MATERIALS AND METHODS
Our study included 17 recipients of ABO-incompatible kidney transplant procedures performed at our institution. At baseline and at 3 and 12 months after conversion, graft biopsies were performed to check for acute rejection and C4d deposition.
RESULTS
Treatment with everolimus was stopped due to adverse events in 8 patients (47.1%). Conversion to everolimus with calcineurin inhibitor minimization did not induce acute rejection or C4d deposition at 3 and 12 months after conversion in ABO-incompatible kidney transplant recipients in whom everolimus was maintained or stopped within 1 year after conversion.
CONCLUSIONS
Everolimus elicited no acute rejection and no C4d deposition, whether everolimus was maintained or stopped within 1 year after conversion, in ABO-incompatible kidney transplant recipients.
目的
在此，我们报告稳定的ABO血型不相容肾移植受者从霉酚酸酯加标准剂量钙调神经磷酸酶抑制剂转换为依维莫司加低剂量钙调神经磷酸酶抑制剂后的1年随访数据。
材料与方法
我们的研究纳入了在本机构接受ABO血型不相容肾移植手术的17名受者。在基线以及转换后3个月和12个月时，进行移植肾活检以检查急性排斥反应和C4d沉积情况。
结果
8名患者（47.1%）因不良事件停止使用依维莫司治疗。在转换后1年内维持或停用依维莫司的ABO血型不相容肾移植受者中，转换为依维莫司并尽量减少钙调神经磷酸酶抑制剂的使用，在转换后3个月和12个月时未诱发急性排斥反应或C4d沉积。
结论
在ABO血型不相容肾移植受者中，无论转换后1年内依维莫司是维持使用还是停用，依维莫司均未引发急性排斥反应和C4d沉积。
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