Yagisawa T, Nakada T, Hiromasa Y, Kaneko H, Tomaru M, Suzuki Y, Iijima Y
Department of Urology, Yamagata University School of Medicine, Japan.
Int Urol Nephrol. 1995;27(4):495-501. doi: 10.1007/BF02550089.
We report two kidney transplant recipients with successful steroid withdrawal. They are living related donor transplant recipients. The first patient, a 37-year-old female, received the kidney from her HLA identical father. The second patient, a 44-year-old man, received the kidney from his HLA 1 haploidentical brother. Both patients were maintained on triple immunosuppressive drug therapy prior to withdrawal of steroid and subsequently were maintained on cyclosporine and azathioprine or mizoribine. Acute rejection occurred within the first 1 month and was treated with steroid bolus therapy successfully in both cases. The time of steroid withdrawal after transplantation was 6.5 months in the first patient and 5 months in the second patient. After steroid withdrawal their graft function remained stable and the graft specimens obtained by biopsy 8 months after withdrawal showed no signs of rejection; no side effects of steroid appeared. These results suggest that steroid withdrawal half a year after transplantation can be accomplished without jeopardizing graft function in selected living related donor transplant recipients.
我们报告了两例成功停用类固醇的肾移植受者。他们均为活体亲属供肾移植受者。首例患者为一名37岁女性，接受了来自与其HLA配型相同的父亲的肾脏。第二例患者为一名44岁男性，接受了来自其HLA单倍型相同的兄弟的肾脏。两名患者在停用类固醇之前均接受三联免疫抑制药物治疗，随后维持使用环孢素和硫唑嘌呤或米唑立宾。两例患者均在术后1个月内发生急性排斥反应，并通过类固醇冲击疗法成功治疗。首例患者移植后停用类固醇的时间为6.5个月，第二例患者为5个月。停用类固醇后，他们的移植肾功能保持稳定，停用8个月后通过活检获取的移植肾标本未显示排斥反应迹象；未出现类固醇的副作用。这些结果表明，对于选定的活体亲属供肾移植受者，移植后半年停用类固醇可在不损害移植肾功能的情况下实现。
