两种免疫诱导方案在DCD供肾移植中的有效性和安全性研究  

Study on the effectiveness and safety of two kinds of immune induction schemes in DCD for kidney transplantation

作　　者：张磊[1] 刘鲁东[2] 官丽辉 ZHANG Lei;LIU Ludong;GUAN Lihui(Department of Surgery,Weifang Medical University,Weifang 261053,China;Department of Urology,Weifang People＇s Hospital)

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053 [2]潍坊市人民医院泌尿外科

出　　处：《潍坊医学院学报》2018年第2期100-102,共3页Acta Academiae Medicinae Weifang

摘　　要：目的观察巴利昔单抗和抗人T细胞兔免疫球蛋白在心脏死亡器官捐献(DCD)供肾移植免疫诱导治疗中的有效性和安全性。方法回顾性分析2015年12月~2017年12月在潍坊市人民医院行同种异体肾移植72例患者的临床资料,比较急性排斥反应发生例数、术后肺部感染、移植肾功能延迟恢复+例数、随访术后半年移植肾带/失功情况。结果巴利昔单抗组和ATG-F组在DCD供肾移植中术后急性排异发生率分别为5.71%,10.81%,DGF发生率分别为8.57%,13.51%,半年内移植肾存活率分别为97.1%,97.2%,以上3方面比较,差异均无显著性。巴利昔单抗组术后肺部发生感染1例,ATG-F组发生感染7例,两组比较差异有显著性(P<0.05)。结论 (1)巴利昔单抗和ATG-F在DCD供肾移植中术后AR发生率、DGF发生率,半年内在移植肾存活方面无明显差别。(2)巴利昔单抗能显著减少DCD供肾移植术后肺部感染的发生率,明显优于ATG-F组。Objective To compare the efficacy and safety of Basiliximab and anti-human T-cell rabbit immunoglobulin in cardiac death organ donation for kidney transplantation. Methods The clinical data of 72 patients with allogeneic renal transplantation performed at the People＇s Hospital of Weifang from December 2015 to December 2017 were retrospectively reviewed. The number of AR cases,postoperative pulmonary infections,DGF cases,and postoperative follow-up were compared. Renal allograft band/loss of work after half a year was followed-up. Results The incidence of acute rejection was 5. 71% and 10. 81% respectively after DCD for kidney transplantation in the basiliximab and anti-human T-cell rabbit immunoglobulin groups. The incidence of DGF was 8. 57% and 13. 51% respectively. The survival rate of transplanted kidneys was 97. 1% and 97. 2%,respectively. There was no statistical difference in the above three aspects（ P〉0. 05）. One case of pulmonary infection occurred in the basiliximab group,and 7 cases of infection occurred in the anti-human T-cell rabbit immunoglobulin group after surgery. There was a significant difference（ P〈0. 05）. Conclusion（1）The incidence of AR and the incidence of DGF in the DCD donor kidney transplantation are similar between the basiliximab and anti-human T-cell rabbit immunoglobulin and there is no significant difference in survival of the transplanted kidney within six months.（2）Basiliximab can significantly reduce the incidence of pulmonary infection after renal transplantation for DCD. This is superior to the anti-human T cell rabbit immunoglobulin group.

关 键 词：肾移植 免疫诱导 巴利昔单抗 抗人T细胞兔免疫球蛋白 

分 类 号：R692[医药卫生—泌尿科学]