• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

因新冠病毒疾病住院的肾移植受者免疫抑制的最小化

Immunosuppression minimization in kidney transplant recipients hospitalized for COVID-19.

作者信息

Anton Pampols Paula, Trujillo Hernando, Melilli Edoardo, Urban Blanca, Sandino Justo, Favá Alexandre, Gutierrez Eduardo, Bestard Oriol, Mancebo Esther, Sevillano Angel, Cruzado Josep M, Morales Enrique

机构信息

Department of Nephrology, IDIBELL, Bellvitge University Hospital, Barcelona, Spain.

Department of Nephrology, University Hospital "12 de Octubre", Madrid, Spain.

出版信息

Clin Kidney J. 2021 Jan 29;14(4):1229-1235. doi: 10.1093/ckj/sfab025. eCollection 2021 Apr.

DOI:10.1093/ckj/sfab025
PMID:34282376
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7929031/
Abstract

BACKGROUND

Immunosuppressed patients such as kidney transplant recipients (KTs) have increased mortality risk in the setting of coronavirus disease 2019 (COVID-19). The role and management of chronic immunosuppressive therapies during COVID-19 must be characterized.

METHODS

Herein, we report the follow-up of a cohort of 47 KTs admitted at two Spanish Kidney Transplant Units, who survived COVID-19. The impact of the management of immunosuppression during COVID-19 on graft function and immunologic events was evaluated.

RESULTS

At least one immunosuppressive agent was withdrawn in 83% of patients, with antimetabolites being the most frequent. Steroids were generally not stopped and the dose was even increased in 15% of patients as part of the treatment of COVID-19. Although immunosuppressive drugs were suspended during a median time of 17 days, no rejection episodes or donor-specific antibodies were observed up to 3 months after discharge, and no significant changes occurred in calculated panel reactive antibodies. Acute graft dysfunction was common (55%) and the severity was related to tacrolimus trough levels, which were higher in patients receiving antivirals. At the end of follow-up, all patients recovered baseline kidney function.

CONCLUSIONS

Our observational study suggests that immunosuppression in KTs hospitalized due to COVID-19 could be safely minimized.

摘要

背景

免疫抑制患者，如肾移植受者（KTs），在2019冠状病毒病（COVID-19）疫情期间死亡风险增加。必须明确COVID-19期间慢性免疫抑制治疗的作用及管理方法。

方法

在此，我们报告了在西班牙两个肾脏移植单位收治的47例COVID-19康复KTs的随访情况。评估了COVID-19期间免疫抑制管理对移植肾功能和免疫事件的影响。

结果

83%的患者至少停用了一种免疫抑制剂，其中抗代谢药物最为常见。作为COVID-19治疗的一部分，类固醇药物通常未停用，15%的患者剂量甚至增加。尽管免疫抑制药物的停用时间中位数为17天，但出院后3个月内未观察到排斥反应或供体特异性抗体，计算的群体反应性抗体也无显著变化。急性移植肾功能障碍很常见（55%），其严重程度与他克莫司谷浓度有关，接受抗病毒药物治疗的患者谷浓度更高。随访结束时，所有患者的肾功能均恢复至基线水平。

结论

我们的观察性研究表明，因COVID-19住院的KTs的免疫抑制可安全地降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/008b8afb1d59/sfab025f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/6953423ab057/sfab025f9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/8132755b23f4/sfab025f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/355436902b2d/sfab025f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/38c98a7ea5f0/sfab025f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/a87202da0d70/sfab025f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/869e4b174a44/sfab025f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/f890fc14f607/sfab025f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/1eac8ebe2329/sfab025f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/008b8afb1d59/sfab025f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/6953423ab057/sfab025f9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/8132755b23f4/sfab025f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/355436902b2d/sfab025f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/38c98a7ea5f0/sfab025f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/a87202da0d70/sfab025f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/869e4b174a44/sfab025f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/f890fc14f607/sfab025f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/1eac8ebe2329/sfab025f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06fd/8284616/008b8afb1d59/sfab025f8.jpg

相似文献

1
Immunosuppression minimization in kidney transplant recipients hospitalized for COVID-19.因新冠病毒疾病住院的肾移植受者免疫抑制的最小化
Clin Kidney J. 2021 Jan 29;14(4):1229-1235. doi: 10.1093/ckj/sfab025. eCollection 2021 Apr.
2
Occurrence of Donor-Specific Antibodies After COVID-19 in Kidney Transplant Recipients Is Low Despite Immunosuppression Modulation.尽管进行了免疫抑制调节，但肾移植受者感染 COVID-19 后供体特异性抗体的发生率较低。
Kidney Int Rep. 2022 May;7(5):983-992. doi: 10.1016/j.ekir.2022.01.1072. Epub 2022 Feb 7.
3
Polyclonal and monoclonal antibodies for treating acute rejection episodes in kidney transplant recipients.用于治疗肾移植受者急性排斥反应的多克隆抗体和单克隆抗体。
Cochrane Database Syst Rev. 2017 Jul 20;7(7):CD004756. doi: 10.1002/14651858.CD004756.pub4.
4
Subtle Changes in Tacrolimus Levels Have an Impact on Early Donor-Specific Antibodies in Kidney Transplantation.他克莫司水平的细微变化对肾移植中早期供体特异性抗体有影响。
Prog Transplant. 2023 Dec;33(4):335-340. doi: 10.1177/15269248231212923. Epub 2023 Nov 9.
5
Kidney allograft recipients, immunosuppression, and coronavirus disease-2019: a report of consecutive cases from a New York City transplant center.肾移植受者、免疫抑制和 2019 年冠状病毒病：来自纽约市移植中心的连续病例报告。
Nephrol Dial Transplant. 2020 Jul 1;35(7):1250-1261. doi: 10.1093/ndt/gfaa154.
6
Immunosuppression management in renal transplant recipients with normal-immunological risk: 10-year results from the Swiss Transplant Cohort Study.正常免疫风险肾移植受者的免疫抑制管理：瑞士移植队列研究的10年结果
Swiss Med Wkly. 2020 Dec 5;150:w20354. doi: 10.4414/smw.2020.20354. eCollection 2020 Nov 30.
7
Minimization of immunosuppressive therapy and immunological monitoring of kidney transplant recipients with long-term allograft survival.长期同种异体肾移植存活受者免疫抑制治疗的最小化及免疫监测
Transpl Immunol. 2008 Nov;20(1-2):3-5. doi: 10.1016/j.trim.2008.08.008. Epub 2008 Sep 4.
8
Outcome after steroid withdrawal in pediatric renal transplant patients receiving tacrolimus-based immunosuppression.接受以他克莫司为基础的免疫抑制治疗的小儿肾移植患者停用类固醇后的结果。
Transplantation. 2000 Sep 15;70(5):760-4. doi: 10.1097/00007890-200009150-00008.
9
COVID-19 Infection in Kidney Transplant Recipients: A Single-Center Case Series of 22 Cases From Belgium.肾移植受者中的新型冠状病毒肺炎感染：来自比利时的22例单中心病例系列
Kidney Med. 2020 Jun 15;2(4):459-466. doi: 10.1016/j.xkme.2020.06.001. eCollection 2020 Jul-Aug.
10
Tacrolimus trough levels higher than 6 ng/mL might not be required after a year in stable kidney transplant recipients.在稳定的肾移植受者中，一年后，他克莫司谷浓度高于 6ng/mL 可能不是必需的。
PLoS One. 2020 Jul 2;15(7):e0235418. doi: 10.1371/journal.pone.0235418. eCollection 2020.

引用本文的文献

1
Serological responses and clinical outcomes following a three-dose primary COVID-19 vaccine schedule in kidney transplant recipients and people on dialysis.肾移植受者和透析患者接种三剂新冠病毒病（COVID-19）初级疫苗后的血清学反应及临床结果
Clin Transl Immunology. 2024 Jul 25;13(7):e1523. doi: 10.1002/cti2.1523. eCollection 2024.
2
Kidney Allograft Rejection and Coronavirus Disease 2019 Infection: A Narrative Review.肾移植排斥反应与2019冠状病毒病感染：一篇叙述性综述
Adv Biomed Res. 2023 Jun 28;12:152. doi: 10.4103/abr.abr_167_22. eCollection 2023.
3
[Update of the recommendations on the management of the SARS-CoV-2 coronavirus pandemic (COVID-19) in kidney transplant patients.].

本文引用的文献

1
AKI Treated with Renal Replacement Therapy in Critically Ill Patients with COVID-19.新冠肺炎危重症患者急性肾损伤行肾脏替代治疗。
J Am Soc Nephrol. 2021 Jan;32(1):161-176. doi: 10.1681/ASN.2020060897. Epub 2020 Oct 16.
2
Multicenter Clinicopathologic Correlation of Kidney Biopsies Performed in COVID-19 Patients Presenting With Acute Kidney Injury or Proteinuria.多中心 COVID-19 患者伴急性肾损伤或蛋白尿行肾活检的临床病理相关性研究
Am J Kidney Dis. 2021 Jan;77(1):82-93.e1. doi: 10.1053/j.ajkd.2020.10.001. Epub 2020 Oct 10.
3
Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe.
[肾移植患者中严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）冠状病毒大流行（COVID-19）管理建议的更新。]
Nefrologia. 2022 Nov 15. doi: 10.1016/j.nefro.2022.11.001.
4
Immune responses to SARS-CoV-2 in dialysis and kidney transplantation.透析和肾移植中对严重急性呼吸综合征冠状病毒2的免疫反应。
Clin Kidney J. 2022 Jul 27;15(10):1816-1828. doi: 10.1093/ckj/sfac174. eCollection 2022 Oct.
5
Can the COVID-19 Pandemic Improve the Management of Solid Organ Transplant Recipients?新冠疫情能否改善实体器官移植受者的管理？
Viruses. 2022 Aug 24;14(9):1860. doi: 10.3390/v14091860.
6
SARS-CoV-2 Vaccination in Solid-Organ Transplant Recipients.实体器官移植受者中的新型冠状病毒 2 型疫苗接种
Vaccines (Basel). 2022 Aug 30;10(9):1430. doi: 10.3390/vaccines10091430.
7
COVID-19 in Kidney Transplant Recipients: A Multicenter Experience from the First Two Waves of Pandemic.肾移植受者中的 COVID-19：来自大流行前两波的多中心经验。
BMC Nephrol. 2022 May 12;23(1):183. doi: 10.1186/s12882-022-02784-w.
8
[Management of immunosuppressive therapy in kidney transplant recipients with COVID19. A multicentre national study derived form the S.E.N. COVID registry.].[新冠病毒肺炎肾移植受者免疫抑制治疗的管理。一项源自西班牙肾脏病学会新冠病毒肺炎登记处的多中心全国性研究。]
Nefrologia. 2022 Apr 30. doi: 10.1016/j.nefro.2022.03.008.
9
Understanding the Risks of Immunosuppression Reduction for Active COVID-19 Infection.了解降低免疫抑制对活动性新冠病毒感染的风险。
Kidney Int Rep. 2022 May;7(5):937-938. doi: 10.1016/j.ekir.2022.03.005. Epub 2022 Mar 12.
10
Late antibody-mediated rejection in a kidney transplant recipient: COVID 19 induced?肾移植受者的晚期抗体介导的排斥反应：COVID-19 引起的？
BMC Nephrol. 2022 Mar 5;23(1):91. doi: 10.1186/s12882-022-02713-x.
欧洲透析患者和肾移植受者的 ERA-EDTA 注册中心研究结果表明，他们因 COVID-19 导致的死亡率很高。
Kidney Int. 2020 Dec;98(6):1540-1548. doi: 10.1016/j.kint.2020.09.006. Epub 2020 Oct 15.
4
A Systematic Review of COVID-19 Infection in Kidney Transplant Recipients: A Universal Effort to Preserve Patients' Lives and Allografts.肾移植受者中新型冠状病毒肺炎感染的系统评价：保护患者生命和同种异体移植物的共同努力
J Clin Med. 2020 Sep 16;9(9):2986. doi: 10.3390/jcm9092986.
5
COVID-19 Outcomes Among Solid Organ Transplant Recipients: A Case-control Study.实体器官移植受者的 COVID-19 结局：一项病例对照研究。
Transplantation. 2021 Jan 1;105(1):128-137. doi: 10.1097/TP.0000000000003447.
6
COVID-19 and solid organ transplant outcomes.新型冠状病毒肺炎与实体器官移植结果
Nephrol Dial Transplant. 2020 Aug 1;35(8):1444-1446. doi: 10.1093/ndt/gfaa207.
7
Clinical characteristics and risk factors for severe COVID-19 in hospitalized kidney transplant recipients: A multicentric cohort study.住院肾移植受者中严重 COVID-19 的临床特征和危险因素：一项多中心队列研究。
Am J Transplant. 2020 Nov;20(11):3030-3041. doi: 10.1111/ajt.16246. Epub 2020 Sep 23.
8
COVID-19 and kidney transplantation: Results from the TANGO International Transplant Consortium.COVID-19 与肾移植：TANGO 国际移植联合会的研究结果。
Am J Transplant. 2020 Nov;20(11):3140-3148. doi: 10.1111/ajt.16185. Epub 2020 Aug 4.
9
Factors associated with COVID-19-related death using OpenSAFELY.使用 OpenSAFELY 分析与 COVID-19 相关死亡的因素。
Nature. 2020 Aug;584(7821):430-436. doi: 10.1038/s41586-020-2521-4. Epub 2020 Jul 8.
10
How should I manage immunosuppression in a kidney transplant patient with COVID-19? An ERA-EDTA DESCARTES expert opinion.对于一名感染了COVID-19的肾移植患者，我应如何管理免疫抑制？欧洲肾脏最佳实践组织（ERA-EDTA）笛卡尔研究组专家意见。
Nephrol Dial Transplant. 2020 Jun 1;35(6):899-904. doi: 10.1093/ndt/gfaa130.