儿童单只供肾移植围术期免疫抑制方案8例总结  

Perioperative Efficacy of Immunosuppression Regimen for Single Kidney Transplantation from Pediatric DCD Donors: A Report of 8 Cases

作　　者：蔡文娥[1] 黄仁彬[2] 孙煦勇[1] 农江[1] 李海滨[1] 覃音红[1] 秦科[1] 蓝柳根[1] 

机构地区：[1]中国人民解放军第303医院器官移植中心暨广西移植医学重点实验室,广州军区肝肾移植中心,南宁市530021 [2]广西医科大学药学院,南宁市530021

出　　处：《广西医学》2014年第6期722-725,共4页Guangxi Medical Journal

基　　金：广西自然科学基金资助项目(0728252);广西医药卫生科研课题(Z2011011)

摘　　要：目的：总结以他克莫司为主的免疫抑制方案在儿童供肾移植围术期的临床应用效果。方法4例3～6岁儿童逝世后捐献供肾移植，8例受者均以他克莫司＋吗替麦考酚酯＋泼尼松为基础免疫治疗，术前采用重组抗CD25人源化单克隆抗体与甲泼尼龙联合诱导治疗。统计手术当日（0 d）、术后3 d、5 d、7 d、14 d、30 d血肌酐值、内生肌酐清除率、T淋巴细胞亚群CD3＋、CD4＋、CD8＋计数、排斥反应及其他不良事件发生率。结果8例受者发生移植肾功能延迟恢复2例，其余6例患者均在术后14 d内移植肾功能恢复正常；CD3＋、CD4＋、CD8＋计数于术后1个月趋于稳定；术后发生急性排斥反应1例，他克莫司中毒1例；未出现感染病例。结论采用重组抗CD25人源化单克隆抗体与甲泼尼龙联合诱导在儿童捐献单只供肾移植围术期可取得较好的临床效果。Objective To summarize the perioperative efficacy of tacrolimus-based immunosuppressive regimen on recipients from pediatric DCD donors undergoing kidney transplantation .Methods The immunosuppressive regimen performed in 8 recipients from 4 DCD donors aged 3-6 years was analyzed retrospectively .The 8 recipients were treated with a basic immunosuppressive regimen of tacrolimus ＋mycophnolate mofetil ＋prednisone ,and were given a induction therapy of recombinant anti-CD25 humanized monoclonal antibody plus methylprednisolone before operation .The levels of serum creatinine（SCr）,creatinine clearance （CrCl）,and CD3＋,CD4 ＋,CD8＋cell counts 0,3,5,7,14,30 days after kidney transplantation were determined ,the incidences of acute rejection and other adverse events were also calculated . Results Among 8 recipients,2 recipients suffered delayed graft function （DGF）,the other 6 recipients showed normal renal function in the first 14 days after operation .The CD3＋,CD4＋,CD8＋cell counts tended to be stable in one month .One case was complicated with acute rejection and 1 case was found tacrolimus nephrotoxicity .No infective case occurred . Conclusion The induction therapy of anti-CD25 recombinant humanized monoclonal antibody plus methylprednisolone is of better effect on recipients from pediatric DCD donors undergoing single kidney transplantation .

关 键 词：肾移植 肾衰竭 组织捐献者 免疫抑制方案 儿童 

分 类 号：R617[医药卫生—外科学]