个体化免疫诱导方案在肾移植中的应用进展  

Application progress of individualized immune induction therapy in kidney transplantation

作　　者：朱焓 徐鸿 梁国标 Zhu Han;Xu Hong;Liang Guobiao(Department of Urology,the Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医科大学附属医院泌尿外科,贵州遵义563000

出　　处：《器官移植》2021年第6期741-747,共7页Organ Transplantation

基　　金：国家自然科学基金(81460135);贵州省教育厅创新群体重大研究项目(黔教合KY字[2017]045);遵义市科技计划项目[遵市科合HZ字(2020)210]。

摘　　要：肾移植术后早期急性排斥反应发生的风险较高,严重影响受者的生存质量。2009年,改善全球肾脏病预后组织(KDIGO)建议将免疫诱导药物纳入肾移植术前免疫诱导方案中,其目的就是针对这一关键时期提供一定强度的免疫抑制,从而有效减少术后急性排斥反应的发生。目前全球各移植中心对于免疫诱导药物的选择及其有效性、安全性仍不确定。本文通过汲取国内外学者的研究成果,对比分析单克隆抗体包括白细胞介素-2受体拮抗剂、阿伦单抗、利妥昔单抗及多克隆抗体抗胸腺细胞球蛋白在肾移植术前免疫诱导中的应用效果,旨在为推动肾移植免疫诱导药物的个体化选择,提高受者的生存质量提供参考。The risk of early acute rejection after kidney transplantation is relatively high,which severely affects the quality of life of the recipients.In 2009,Kidney Disease:Improving Global Outcomes(KDIGO)recommended that immune inducers should be included in the immune-inducing regime before kidney transplantation,aiming to provide certain strength of immunosuppression during this critical phase and effectively reduce the incidence of acute rejection following kidney transplantation.At present,the selection,efficacy and safety of immune inducers remain controversial among transplantation centers around the world.In this article,clinical efficacy of monoclonal antibodies including interleukin-2 receptor antagonist,alemtuzumab,rituximab and polyclonal antibody antithymocyte globulin in immune induction therapy before kidney transplantation were compared and literature review was performed at home and abroad,aiming to provide reference for promoting the individualized selection of immune inducers for kidney transplantation and improving the quality of life of recipients.

关 键 词：肾移植 免疫诱导 多克隆抗体 单克隆抗体 白细胞介素-2受体拮抗剂 阿伦单抗 利妥昔单抗 抗胸腺细胞球蛋白 

分 类 号：R617[医药卫生—外科学] R392.4[医药卫生—临床医学]