FK506 conversion for intractable rejection of the liver allograft
FK506 conversion for intractable rejection of the liver allograft
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FK506 转化用于治疗同种异体肝移植的顽固性排斥反应
DOI：
10.1111/j.1432-2277.1993.tb00672.x
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发表时间：
1993
影响因子：
3.1
通讯作者：
R. Busuttil
中科院分区：
文献类型：
--
作者：
S. McDiarmid;G. Klintmalm;R. Busuttil
27例肝移植术后出现顽固性、经活检证实的急性或慢性排斥反应（定义为胆管消失综合征）的受者，停用环孢菌素后改用FK 506。15例急性排斥反应中9例转复成功，12例胆管消失综合征中6例转复成功。急性排斥反应患者胆红素恢复正常（1个月内）比慢性排斥反应患者（3个月内）更快。转换前总胆红素低于12 mg/dl被认为是成功结局的重要因素（P=0.002）。急性排斥反应的移植物存活率为66.7%，患者存活率为73%，慢性排斥反应的移植物存活率为50%，患者存活率为66.7%。肾毒性、神经毒性和胃肠副作用是FK 506转换的最严重并发症。10例患者中有6例患者的GFR下降≥ 50%，至少暴露1个月的FK 506。将FK 506血清水平维持在0.5-1.5 ng/ml的FK 506平均维持剂量为0.07 mg/kg/12 h（推荐剂量的一半），成人患者为0.15 mg/kg/12 h。这项研究表明，FK 506可以成功地用于转换患有难治性急性和慢性排斥反应的患者。需要仔细调整FK 506的剂量和水平，以尽量减少副作用。
Twenty-seven liver transplant recipients with intractable, biopsy-proven, acute or chronic rejection (defined as vanishing bile duct syndrome) were conerted from cyclosporin to FK506. Successful conversion was achieved in 9 of 15 patients with acute rejection and in 6 of 12 patients with vanishing bile duct syndrome. A normal bilirubin was achieved more quickly in those with acute rejection (within 1 moth) than in those with chronic rejection (within 3 months). A preconversion total bilirubin of less than 12 mg/dl was considered significant with regard to a successful outcome (P=0.002). Graft survival was 66.7% and patient survival 73% in the case of acute rejection, and 50% and 66.7%, respectively, in the case of chronic rejection. Nephrotoxicity, neurotoxicity, and gastroitestinal side effects were the most serious complications of FK506 conversion. Six of ten patients had a drop in GFR that was 50% or greater a minimum of 1 month of FK506 exposure. The mean maintenance dose of FK506 to maintain FK506 serum levels of 0.5–1.5 ng/ml was 0.07 mg/kg per 12 h for adults (half the recommended dose), compared to 0.15 mg/kg per 12 h for pediatric patients. This study demonstrates that FK506 can be used successfully to convert patients with intractable acute and chronic rejection. Careful adjustments of FK506 dosages and levels are required to minimize side effects.
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使用 FK 506 作为肝移植主要治疗的早期试验。
影响因子：
0.9
作者：
Todo,S;Fung,JJ;Demetris,AJ;Jain,A;Venkataramanan,R;Starzl,TE
通讯作者：
Starzl,TE
对接受 FK 506 治疗的肝脏受者进行口服葡萄糖耐量测试。
影响因子：
0.9
作者：
Mieles,L;Todo,S;Fung,JJ;Jain,A;Furukawa,H;Susuki,M;Starzl,TE
通讯作者：
Starzl,TE
造血的免疫控制：同种异体骨髓移植后移植物质量的影响。
影响因子：
0.9
作者：
Mangan,KF
通讯作者：
Mangan,KF
DOI：
--
发表时间：
1989
期刊：
--
影响因子：
--
作者：
T. Starzl;S. Todo;J. Fung;A. Demetris;R. Venkataramanan;A. Jain
通讯作者：
T. Starzl;S. Todo;J. Fung;A. Demetris;R. Venkataramanan;A. Jain
影响因子：
56.9
作者：
SCHREIBER, SL
通讯作者：
SCHREIBER, SL