他克莫司和霉酚酸酯在肾移植术后早期肝功能不良者的应用  

Combined use of Prograf and MMF in early stage of kidney transplantation with liver function dysfunction

作　　者：林正斌[1] 刘斌[1] 明长生[1] 曾凡军[1] 夏穗生[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院器官移植研究所,武汉430030

出　　处：《中华器官移植杂志》2002年第1期54-55,共2页Chinese Journal of Organ Transplantation

摘　　要：目的　分析和评价肾移植术后早期肝功能不良患者使用他克莫司 (FK5 0 6 )和霉酚酸酯(MMF)的有效性和安全性。方法　 2 0例肾移植患者术后早期发生肝功能不良 ,17例 (85 .0 % )丙氨酸转氨酶 (ALT)升高 ,9例 (4 5 .0 % )胆红素升高。发生肝功能不良时 ,停用环孢素A(CsA)和硫唑嘌呤 (Aza) ,采用FK5 0 6、MMF和泼尼松三联用药 ,常规使用保肝及利胆治疗。结果　 2 0例肾移植术后肾功能全部恢复正常 ,未发生急性排斥反应 ;治疗 2周后 ,82 .4%患者 (14/ 17)ALT恢复正常 ,4周后全部患者的ALT恢复正常。结论　FK5 0 6和MMF用于肾移植术后早期肝功能不良患者是安全的 。Objective To analyze and evaluate the efficacy and safety of Prograf in combination with MMF in kidney transplant recipients with liver dysfunction in the early stage of postoperation. Method Among the 20 cases of liver dysfunction in the early stage of posttransplant period, ALT and BIL were increased in 17 cases (85 %) and 9 cases (45 %) respectively. The triple-combined immunosuppressive protocol with Prograf, MMF and Pred was administrated just while CsA and Aza were stopped. Active therapy was co-administrated to decrease liver injury and protect liver function as well.Result Kidney function recovered and no rejection occurred in all patients in 20 cases after renal transplantation. ALT recovered in 82.4 % patients (14/17) after treatment for 2 weeks and in all patients after treatment for 4 weeks.Conclusion Prograf and MMF are potent immunosuppressive agents without liver function damage. When administrated in combination in kidney transplant recipients with liver dysfunction, they neither worsen liver injury nor increase the incidence of acute rejection.

关 键 词：肾移植 肝疾病 免疫抑制剂 他克莫司 霉酚酸酯 

分 类 号：R699.2[医药卫生—泌尿科学]