McVicar J P, Kowdley K V, Emond M J, Barr D, Marsh C L, Carithers R L, Perkins J D
Department of Surgery, University of Washington School of Medicine, Seattle, USA.
Clin Transplant. 1997 Aug;11(4):328-33.
Despite advances in immunosuppression, allograft rejection occurs frequently after liver transplantation. The use of induction therapy with cytolytic antibodies may decrease the frequency of rejection in liver transplant recipients, but may also increase the rate of cytomegalovirus (CMV) infection. It has been our center's strategy to use induction therapy in our liver transplant recipients. To determine the outcome of our strategy, we retrospectively reviewed all liver transplants performed in the first 5 yr of our liver transplant program. The frequency of acute rejection in the first year after liver transplantation was only 34% in patients who received induction therapy. The type of induction therapy antibody did not affect the rejection rate. Clinically significant CMV infection (requiring treatment) occurred in 22% of patients. These results suggest that use of induction therapy with cytolytic antibodies does not lead to a high incidence of CMV infection and decreases the incidence of rejection after liver transplantation.
尽管免疫抑制取得了进展，但肝移植后同种异体移植排斥反应仍频繁发生。使用溶细胞抗体进行诱导治疗可能会降低肝移植受者的排斥反应频率，但也可能增加巨细胞病毒（CMV）感染率。我们中心的策略是在肝移植受者中使用诱导治疗。为了确定我们这一策略的结果，我们回顾性分析了在我们肝移植项目的前5年中进行的所有肝移植手术。接受诱导治疗的患者在肝移植后第一年的急性排斥反应频率仅为34%。诱导治疗抗体的类型并不影响排斥率。22%的患者发生了具有临床意义的CMV感染（需要治疗）。这些结果表明，使用溶细胞抗体进行诱导治疗不会导致CMV感染的高发生率，并且会降低肝移植后排斥反应的发生率。
