雷帕霉素在合并急性肾功能不全肝移植患者中的初步应用  

Application of rapamycin in liver transplant patients with acute kidney malfunction

作　　者：王轩[1] 吴幼民[1] 许正昌[1] 张斌[1] 李增才[1] 陆雷[1] 郑以山[1] 

机构地区：[1]中国人民解放军八一医院肝移植中心,江苏省南京市210002

出　　处：《世界华人消化杂志》2006年第30期2974-2976,共3页World Chinese Journal of Digestology

摘　　要：目的:探讨雷帕霉素(rapamycin,Rap)对合并急性肾功能不全肝移植患者术后急性排斥反应的抑制作用及对肾功能的影响．方法:对25例合并急性肾功能不全肝移植患者术后常规采用以Rap为主的免疫抑制方案,观察移植术后急性排斥反应发生及肾功能的变化．结果:25例患者均随访,23例存活至今,最长存活已达34 mo．术后3 mo内急性排斥反应发生率4％．所有存活患者肾功能均在3 mo内恢复至正常范围,术前肾功能有损害者,术后血肌酐恢复正常所需要时间为(45±19 d),较术前肌酐正常者(24±15 d)长．结论:以Rap为主免疫抑制方案完全可预防合并急性肾功能不全肝移植患者术后急性排斥反应发生,同时不影响移植术后肾功能的恢复．AIM： To explore the preventive effect of rapamycin on acute allograft rejection and kidney function recovery in liver transplant patients with acute kidney malfunction. METHODS： A total of 25 liver transplant patients with acute kidney malfunction received rapamycin treatment as preventive measures for acute allograft rejection. Both the rejection rate and the change of kidney function were monitored. RESULTS： Of the 25 cases, 23 survived till today with the longest time of 34 mo. The 3-mo acute rejection rate was 4%, and the kidney function of the 23 patients recovered to the normal range within 3 mo. It took more time to recover for the patients with impaired kidney function （45 ± 19 d） than that for the ones with normal kidney function （24 ± 15 d） before operation （P 〈 0.01）. CONCLUSION： Rapamycin can prevent the occurrence of acute allograft rejection for liver transplant patients with acute kidney malfunction, while not affect the recovery of kidney function.

关 键 词：雷帕霉素 肝移植 急性肾功能不全 急性排斥反应 

分 类 号：R657.3[医药卫生—外科学] R692.5[医药卫生—临床医学]