Lindholm A, Albrechtsen D, Flatmark A, Tufveson G, Persson N H, Frödin L, Groth C G
Department of Transplantation Surgery, Huddinge Hospital, Sweden.
Transpl Int. 1994 May;7(3):207-15. doi: 10.1007/BF00327089.
A total of 195 consecutive recipients of primary living donor renal transplants were randomized to receive either cyclosporin (CyA) and prednisolone (double therapy) or CyA, prednisolone, and azathioprine (triple therapy). There was no significant difference in patient or graft survival, incidence of acute rejection episodes, or major complications between the groups. The graft survival at 5 years was 71.5% in patients receiving double therapy and 71.6% in patients receiving triple therapy. In a Cox regression analysis, recipient age and occurrence of acute rejection were the only independently significant variables affecting graft survival, whereas treatment schedule did not. Renal function was stable throughout the observation period and did not differ between the double and triple therapy groups. A linear regression analysis showed that recipient age, donor age, gender, and occurrence of acute rejection significantly influenced the serum creatinine level. This and previous similar prospective studies in cadaveric renal transplantation indicate that there is no advantage of routinely adding azathioprine to a double drug regimen.
总共195例接受活体供肾初次移植的受者被随机分组，分别接受环孢素（CyA）和泼尼松龙（双联疗法）或环孢素、泼尼松龙和硫唑嘌呤（三联疗法）。两组在患者或移植物存活率、急性排斥反应发生率或主要并发症方面无显著差异。接受双联疗法的患者5年移植物存活率为71.5%，接受三联疗法的患者为71.6%。在Cox回归分析中，受者年龄和急性排斥反应的发生是影响移植物存活的仅有的独立显著变量，而治疗方案并非如此。在整个观察期内，肾功能稳定，双联疗法组和三联疗法组之间无差异。线性回归分析表明，受者年龄、供者年龄、性别和急性排斥反应的发生显著影响血清肌酐水平。本研究以及先前在尸体肾移植中进行的类似前瞻性研究表明，在双联药物方案中常规添加硫唑嘌呤并无优势。
