Salvatierra O, Melzer J, Vincenti F, Amend W J, Tomlanovich S, Potter D, Husing R, Garovoy M, Feduska N J
Transplant Proc. 1987 Feb;19(1 Pt 1):160-6.
DST provides excellent graft survival in one- and zero-haplotype-matched donor-recipient pairs as well as a trend towards improving graft survival in HLA-identical matches; serum creatinine levels are good in functioning grafts; Imuran coverage does appear to decrease DST sensitization to the blood donor in nonsensitized patients undergoing a first transplant, which encourages early DST and transplantation in this group; flow cytometry has been extremely helpful in excluding subliminal anti-class 1 antigen activity in patients with positive B warm crossmatches alone; DST, in itself, does not appear to preclude subsequent cadaveric transplantation in patients sensitized to their blood donor; and the family history of the blood donor is known, with essentially no risk to the recipients of hepatitis, AIDS, etc. In regards to the issue of whether DST or Cs is better, both have merits, and one must be aware of the circumstances that relate to the optimum application of each therapy. Only a prospective study of DST- and Cs-treated patients with a long-term follow-up will probably resolve the issue of the optimum regimen for one-haplotype-matched living related donor-recipient pairs. The ultimate strategy may involve the selective use of each regimen for the most appropriate circumstances.
在单倍型匹配和零单倍型匹配的供受者对中，亲属供肾移植提供了出色的移植物存活率，在 HLA 全相合匹配中也有提高移植物存活率的趋势；功能良好的移植物血清肌酐水平正常；在首次移植的未致敏患者中，硫唑嘌呤似乎确实能降低亲属供肾移植对献血者的致敏性，这鼓励了该组患者早期进行亲属供肾移植和移植手术；流式细胞术在仅 B 淋巴细胞交叉配型阳性的患者中排除潜在的抗 1 类抗原活性方面极其有用；亲属供肾移植本身似乎并不排除对献血者致敏的患者随后接受尸体肾移植；并且献血者的家族病史已知，对受者基本不存在肝炎、艾滋病等风险。关于亲属供肾移植还是环孢素更好的问题，两者都有优点，必须了解与每种治疗最佳应用相关的情况。只有对接受亲属供肾移植和环孢素治疗的患者进行长期随访的前瞻性研究，才可能解决单倍型匹配的亲属活体供受者对最佳治疗方案的问题。最终策略可能包括在最合适的情况下选择性使用每种方案。
