Niaudet P
Service de Néphrologie Pédiatrique, Hôpital des Enfants-Malades, Paris.
Arch Fr Pediatr. 1988;45 Suppl 1:741-4.
The success of organ transplantation depends mostly on immunosuppressive treatments which depress the host vs allograft immune response. The drugs mostly used in the past, Azathioprine and Corticosteroids, act in a non specific way. Heterologous antilymphocyte sera are progressively replaced by monoclonal antibodies specific of lymphocyte subpopulations, such as OKT3 which is a highly potent immunosuppressive agent. Cyclosporin, a new original immunosuppressive agent which acts specifically on T lymphocytes, has considerably improved organ graft survival rates especially for heart and liver. Moreover, it allows reduction of the doses or corticosteroids given after transplantation an thus limits their side-effects, especially on statural growth. However, cyclosporin nephrotoxicity represents the major problem, at least in the long-term.
器官移植的成功主要取决于免疫抑制治疗，这种治疗可抑制宿主对同种异体移植物的免疫反应。过去最常用的药物硫唑嘌呤和皮质类固醇以非特异性方式起作用。异源抗淋巴细胞血清逐渐被针对淋巴细胞亚群的单克隆抗体所取代，例如OKT3，它是一种高效的免疫抑制剂。环孢素是一种新型的原创免疫抑制剂，它特异性作用于T淋巴细胞，显著提高了器官移植的存活率，尤其是心脏和肝脏移植。此外，它还能减少移植后给予的皮质类固醇剂量，从而限制其副作用，尤其是对身高增长的影响。然而，至少从长期来看，环孢素的肾毒性是主要问题。
