An increased incidence of late acute rejection episodes in cadaver renal allograft recipients given azathioprine, cyclosporine, and prednisone.
An increased incidence of late acute rejection episodes in cadaver renal allograft recipients given azathioprine, cyclosporine, and prednisone.
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给予硫唑嘌呤、环孢素和泼尼松的尸体肾同种异体移植受者晚期急性排斥反应的发生率增加。
DOI：
10.1097/00007890-199008000-00012
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发表时间：
1990
期刊：
影响因子：
6.2
通讯作者：
Najarian,JS
中科院分区：
文献类型：
--
作者：
Wrenshall,LE;Matas,AJ;Canafax,DM;Min,DI;Sibley,RJ;Dunn,DL;Payne,WD;Sutherland,DE;Najarian,JS
我们研究了身体肾移植受者在移植后1年内发生的经活检证实的急性排斥反应的发生率。接受评估的328名患者接受了三种免疫抑制药物方案的治疗。I组(移植9/80~6/84)(n=75)接受硫唑嘌呤、强的松(P)和抗淋巴细胞球蛋白治疗，II组(移植9/80~6/84)(n=83)接受环孢素和P，III组(移植7/84~12/86)(n=170)接受ALG、AZA、CsA和P(序贯治疗)。移植后1年内首次急性排斥反应发生率I组为55%，II组和III组为35%，晚期急性排斥反应发生率分别为I组6.5%、II组2.5%和III组9.5%(P=0.02)。在第三组中，50%的晚期拒绝是第一次，44%第二次，6%第三次。晚期急性排斥反应发生率增加的主要原因可能包括CsA亚治疗水平和较低的P剂量。序贯免疫抑制治疗已被证明在移植后第一年是有利的。然而，除非有足够的IMMU-
We studied the incidence of biopsy-proven, acute rejection episodes occurring after 1 year posttransplant in cadaver renal allograft recipients. The 328 patients evaluated were given three immunosuppressive drug protocols. Group I (transplanted 9/80–6/84)(n= 75) received azathioprine, prednisone (P), and antilymphoblast globulin; group II (transplanted 9/80–6/84)(n= 83) received cyclosporine and P; group III (transplanted 7/84–12/86)(n= 170) received ALG, AZA, CsA, and P (sequential therapy). The incidence of first acute rejection episodes occurring up to 1 year posttransplant was 55% in group I and 35% in groups II and III. The incidence of late (> 1 year) acute rejection episodes was 6.5% in group I, 2.5% in group II, and 9.5% in group III (group II vs. III, P= 0.02). In group III, 50% of the late rejections were first, 44% second, and 6% third. The primary etiologies of this increased incidence of late acute rejection may have included subtherapeutic CsA levels and lower P doses. Sequential immunosuppressive therapy has been shown to be advantageous in the first posttransplant year. However, unless adequate immu-