肾移植受者新发恶性肿瘤后免疫抑制方案的调整  

Immunosuppressive therapy for kidney transplant recipients with de novo cancers

作　　者：苗芸[1] 于立新[1] 邓文锋[1] 付绍杰[1] 徐健[1] 杜传福[1] 王亦斌[1] 叶桂荣[1] 张新科[1] 周敏捷[1] 

机构地区：[1]南方医科大学南方医院器官移植科,广州510515

出　　处：《中华移植杂志（电子版）》2011年第3期21-25,共5页Chinese Journal of Transplantation(Electronic Edition)

基　　金：2010年广东省自然科学基金(0451051501005789);2010年广东省医学科研基金(B2010196)

摘　　要：目的总结肾移植后新发恶性肿瘤患者免疫抑制治疗方案的调整经验。方法分析1978年1月至2011年6月期间3279例肾移植受者中67例新发恶性肿瘤患者的临床资料。结果术后新发恶性肿瘤中,泌尿生殖系统恶性肿瘤最为常见(56.7%)。予以外科手术与免疫抑制剂减至半量或将钙调磷酸酶抑制剂转换为雷帕霉素相结合的个体化治疗方案。5年患者存活率为30%。结论对于移植后新发肿瘤患者,宜采取外科手术与免疫抑制剂减量或换药相结合的个体化治疗方案。Objective To summarize the immunosuppressive therapy for kidney transplant recipients who developed cancers after transplantation.Method De novo cancer data in 67 transplant recipients during January 1978 to June 2011 were collected.Result Overall incidence rate for de novo malignancy posttransplantation was 2.0%（67/3279）.Cancers derived from urinary and reproductive organs were the most common（56.7%）.Most recipients were treated by surgery and were administered with reduced dose of immunosuppression agents or switch from calcineurin inhibitors to sirolimus.Five-year survival rate was 30%.Conclusion Individualizd therapy including surgery and immunosuppression reduction or conversion from CNI to SRL could help recipients with de novo malignancies after transplantation.

关 键 词：肾移植 恶性肿瘤 免疫抑制 个体化治疗 

分 类 号：R699[医药卫生—泌尿科学]