亲属活体供肾移植后低剂量钙调蛋白酶抑制剂的应用

背景：亲属活体肾移植供、受者移植前准备充分,供肾热、冷缺血时间较短,HLA配型的组织相容性好,移植后排斥反应发生率低,为亲属活体供肾肾移植后采用低剂量免疫抑制剂方案提供了可能性。 目的：探讨亲属活体供肾移植后低剂量钙调蛋白酶抑制剂的安全性和有效性。 方法：选取2006-01/2008-06在南京医科大学第一附属医院肾移植中心行亲属活体供肾移植的受者38例,移植后常规使用环孢素A/他克莫司+吗替麦考酚酯+泼尼松的三联免疫抑制方案。将38例患者随机分为两组：CNI常规剂量组(n=18),移植后初始药物剂量为环孢素A 6 mg/(kg•d)或他克莫司0.12 mg/(kg•d);CNI低剂量组(n=20),术后初始药物剂量为环孢素A 4 mg/(kg•d)或他克莫司0.08 mg/(kg•d);两组吗替麦考酚酯和泼尼松使用剂量相同。移植后密切随访,比较两组患者移植后不同时期的肾功能以及急性排斥反应、肺部感染、肝功能损害、肾毒性等并发症的发生情况。 结果与结论：随访12个月,CNI常规剂量组重度肺部感染死亡1例,CNI低剂量组无死亡病例。两组移植肾功能及急性排斥反应发生率比较差异均无显著性意义(P > 0.05);CNI低剂量组肝功能损害、钙调蛋白酶抑制剂肾毒性发生率显著低于CNI常规剂量组 (P < 0.05)。此外,采用低剂量钙调蛋白酶抑制剂免疫抑制方案明显减轻了亲属肾移植患者的经济负担。说明亲属活体供肾移植后采用低剂量钙调蛋白酶抑制剂的免疫抑制剂方案安全、有效。     

夫妻活体供肾移植与血缘亲属供肾移植

背景：夫妻间活体肾移植尽管在组织配型方面差于血缘关系供肾移植,但在临床实践观察中夫妻肾移植与血缘关系肾移植间近期疗效并无明显差异。 目的：对比同期实施的夫妻活体供肾移植和血缘亲属供肾移植的临床疗效,总结夫妻活体供肾移植的临床经验。 方法：回顾性分析郑州人民医院实施的夫妻活体供肾移植18例及血缘亲属供肾移植100例的临床资料,通过对两组移植前组织配型情况和移植后(1,3,6个月)肾功能恢复情况,移植肾功能延迟恢及半年内急性排斥反应发生率、感染发生率等指标的分析,对夫妻活体供肾移植和血缘亲属供肾移植的临床疗效进行比较。 结果与结论：同期进行的18例夫妻活体供肾移植组织配型情况较血缘关属供肾移植患者情况差。在移植方案及免疫抑制治疗方案相同的情况下,夫妻活体供肾移植后6个月内血肌酐恢复情况、术后移植肾功能延迟恢、急性排斥反应发生率、感染发生率,均与同期进行的血缘亲属活体供肾移植差异无显著性意义(P > 0.05)。结果表明,无血缘关系的夫妻间供肾移植与血缘亲属供肾移植治疗效果相近。     

血清可溶性血管细胞粘附分子1测定在肾移植急性排斥反应中的临床意义

采用酶联免疫吸附法（ Ｅ Ｌ Ｉ Ｓ Ａ） 监测５６ 例肾移植患者术后血清可溶性血管细胞粘附分子 １ （ｓ Ｖ Ｃ Ａ Ｍ １ ） 水平的变化,旨在探讨其在肾移植术后免疫学监测中的价值。结果发现： 肾移植患者术后ｓ Ｖ Ｃ Ａ Ｍ １ 水平呈规律性变化, 急性排斥反应组ｓ Ｖ Ｃ Ａ Ｍ １ 水平明显高于移植肾功能稳定组和环胞素 Ａ（ Ｃｓ Ａ） 肾中毒组, 差异非常显著（ Ｐ＜ ００１ ） ; 与排斥反应前水平比较, 差异亦非常显著（ Ｐ＜ ００１ ） 。对激素治疗敏感的排斥反应, ｓ Ｖ Ｃ Ａ Ｍ １ 逐渐降至正常水平; 耐激素的排斥反应应用 Ａ Ｔ Ｇ 治疗后, ｓ Ｖ Ｃ Ａ Ｍ １ 在排斥反应后１ 个月内仍维持在较高水平。 Ｃｓ Ａ 肾中毒组, ｓ Ｖ Ｃ Ａ Ｍ １ 水平无明显变化。结果表明,肾移植术后动态监测ｓ Ｖ Ｃ Ａ Ｍ １ 水平的变化, 有助于急性排斥反应的诊断和鉴别诊断, 有助于指导临床治疗。     

恒河猴肝移植后急性排斥反应中热休克蛋白70的早期诊断价值

背景：热休克蛋白是生物体在不利环境因素刺激下应激合成的一种特殊蛋白质,热休克蛋白70参与移植免疫反应并发挥重要作用。 目的：探讨热休克蛋白70在恒河猴肝移植后急性排斥反应中的早期诊断价值。 方法：选用健康恒河猴采用改良二袖套+肝动脉重建的方法进行同种异体原位肝移植16例,移植后受体分为急性排斥组和对照组,每组8只,急性排斥组围手术期不行免疫抑制治疗,对照组围手术期使用免疫抑制治疗,分别在移植后6,12,24,72 h 4个时间点取移植后肝脏组织进行苏木精-伊红染色以判断排斥反应程度,western blotting检测肝组织中热休克蛋白70表达水平,免疫组化检测肝组织热休克蛋白70表达情况。 结论与结论：肝移植后72 h时段内急性排斥组肝脏急性排斥反应的组织学表现重于对照组,Baff分级水平高于对照组(P < 0.05),从移植后开始至移植后72 h两组移植肝经免疫组化和western blotting检测热休克蛋白70表达水平均有所升高,但急性排斥组要明显高于对照组(P < 0.05)。提示,未使用免疫抑制治疗的情况下,恒河猴肝移植后早期急性排斥反应在移植后72 h内即可明显观察到,热休克蛋白70在移植肝组织中表达水平也随着急性排斥反应的发生进展呈现明显上升趋势,对肝移植后早期急性排斥具有较高的预测和诊断价值。     

血清sPTA1与人活体小肠移植急性排斥反应的相关性评价

目的 观察我国首例父子间活体小肠部分移植术患者围手术期血清可溶性血小板／Ｔ细胞活化抗原１（ｓＰＴＡ１）水平与排斥反应的相关性。方法 用夹心ＥＬＩＳＡ法测定轿清ｓＰＡ１水平。结果 于术后第６７ｄ出现移植物排斥反应。从发生排斥反应前２周开始,ｓＰＴＡ１呈逐渐升高趋势,于排斥反应前５ｄ已达６０．４９ｎｇ／ｍｌ,前１ｄ达７１．６４ｎｇ／ｍｌ。经加强免疫抑制后,血清ＰＴＡ１水平于次日迅速下降。结论 活体部分     

肾移植后早期监测环孢素A血药浓度峰值的临床意义

背景：近几年有报道,检测环孢素A的峰浓度可以更准确地反映环孢素A在体内的药代动力学变化,指导移植后的临床用药比检测谷浓度更合理,而对大样本临床资料统计的研究报道较少。 目的：探讨肾移植后早期监测环孢素A血药浓度峰值对判定环孢素A抗排异疗效及毒副作用的临床意义。 方法：采用单抗免疫荧光偏振法同步监测环孢素A全血谷浓度和峰浓度,回顾性分析78例肾移植受者,移植后观察6个月,48例未发生任何移植后并发症设为正常组,16例发生急性排异反应设为急性排斥反应组,14例出现药物性损害设为药物损害组,观察各组谷浓度及峰浓度在患者发生急性排斥反应或药物毒性时的变化。 结果与结论：移植后各时间段发生急性排异患者环孢素A谷浓度与未发生的比较,差异无显著性意义(P  > 0.05),而各时间段发生急性排斥反应患者环孢素A峰浓度明显低于正常组(P < 0.05)。移植后1个月内,发生药物性肝损害、肾中毒患者谷浓度和峰浓度均明显高于未发生的(P  < 0.05)。移植后2~6个月,药物性肝损害、肾中毒组谷浓度与常组比较差异无显著性意义(P  > 0.05),而峰浓度明显高于正常组(P < 0.05)。提示,监测环孢素A峰浓度能有效预测肾移植后急性排异反应的发生;移植后2~6个月监测环孢素A峰浓度能有效预测肾移植后药物性肝损害、肾中毒的发生。     

夫妻间活体供肾移植

背景：近几年随着各项移植法规相继出台,中国做为器官移植大国,发展迅速,除了尸体肾移植外,活体肾移植亦得到健康快速发展,夫妻供肾做为没有直接血缘关系的活体移植,在器官移植界占据着重要地位。 目的：观察夫妻间供肾亲属活体肾移植的疗效。 方法：郑州人民医院器官移植科2008-10/2010-09进行夫妻间供肾移植11例,同期尸体供肾肾移植83例为对照组。两组受者均采用供肾静脉与髂外静脉端侧吻合,供肾动脉与髂内动脉端端吻合,输尿管-膀胱乳头式吻合,隧道包埋。免疫抑制诱导方案采用甲基泼尼松龙,基础免疫抑制采用钙调磷酸酶抑制剂(他克莫司或环孢素)、吗替麦考酚酯、肾上腺皮质激素(激素)三联免疫治疗,根据血药谷浓度调整他克莫司或环孢素的用量。移植后6个月内进行随访,评价两组受者移植后的肾功能恢复及早期并发症发生情况。 结果与结论：肾移植后两组急性排斥反应、移植物功能延迟恢复等早期并发症发生率比较,夫妻肾移植组优于尸体肾移植组,差异有显著性意义(P < 0.05)。结果提示夫妻间肾移植由于移植前准备充分,肾脏缺血时间短及夫妻间长期共同生活产生相应的免疫耐受,其疗效优于同样无血缘关系的尸体供肾移植。     

高压氧对小鼠皮肤移植术后脾T淋巴细胞及其表面粘附分子变化的研究

目的：探讨环孢素Ａ 和高压氧对同种异体小鼠皮肤移植排斥反应的影响。方法：采用免疫荧光染色技术和流式细胞仪,观察不同处理因素对小鼠脾淋巴细胞ＣＤ＋３ 、ＣＤ＋４ 、ＣＤ＋８ 细胞百分率及Ｔ 淋巴细胞表面粘附分子ＬＦＡ－ １（ＣＤ１１ａ／ＣＤ１８） 表达的影响。结果：高压氧组、环孢素Ａ 组、高压氧＋ 环孢素Ａ 组与对照组比较有显著差异（ Ｐ＜ ０－０１） ,且环孢素Ａ＋ 高压氧组与环孢素Ａ 组、高压氧组比较也有显著差异。结论：高压氧和环孢素Ａ 均能抑制小鼠移植排斥反应,且二者联合应用效果更显著。     

血清可溶性血管细胞粘附分子—1测定在肾移植急性排斥反 …

采用酶联免疫吸附法监测５６例肾移植患者术后血清可溶性血管细胞粘附分子－１水平的变化,旨在探讨其在肾移植术后免疫学监测中的价值。结果发现：肾移植患者术后ｓＶＣＡＭ－１水平呈规律性变化,急性排斥反应组ｓＶＣＡＭ－１水平明显高于移植肾功能稳定组和环胞素Ａ肾中毒组,差异非常显著;与排斥反应前水平比较,     

活体供肾与尸体供肾:1个器官移植中心2年65:169例肾移植效果比较

背景:活体供肾移植的数量在部分医院已经超过尸体供肾移植,但其安全性、优越性、手术技巧、其所面临的伦理学问题还有待进一步探讨。目的:回顾总结同期完成的活体供肾移植及尸体供肾移植的临床经验,分析不同肾脏来源的肾脏移植术后疗效。方法:收集2006-01/2008-03在解放军第309医院全军器官移植中心接受活体供肾移植的65例受者、接受尸体供肾移植169例受者的临床资料,对不同肾脏来源受者的性别、年龄、HLA位点配型、手术情况、术中和术后近、远期并发症、免疫抑制方案、肾功能恢复情况及长期随访资料进行对照研究,进一步明确活体亲属供肾移植的临床意义。结果与结论:65例活体供肾移植手术均获成功,人/肾1年存活率为100%;尸体供肾移植手术成功,2例因术后3个月出现脑出血等非感染并发症死亡,6例在术后1年内因重症肺部感染呼吸衰竭死亡,人/肾1年存活率95.26%。两种不同来源的肾脏移植在并发症以及人/肾1年存活率等指标上活体供肾移植优于尸体供肾移植。活体供肾移植等待时间短,组织配型好,供肾缺血时间短,排斥反应发生少,移植肾存活率高,是一种安全可行的治疗手段。     

活化T细胞核因子在环孢素A抑制原位肝移植后干扰素-γ基因转录中的作用（英文）

目的:研究原位肝移植后环孢素A(CsA)应用前后,活化T细胞核因子(NFAT)的DNA结合活性与干扰素γ基因转录水平变化之间的关系。方法: 采用大鼠原位肝移植模型,用凝胶电泳迁移试验(EMSA)和逆转录聚合酶链反应(RT-PCR)的方法,分别测定移植后CsA治疗组和非治疗组脾细胞NFAT的DNA结合活性及移植肝组织中IFN-γ mRNA的表达水平,并以病理形态学变化作参照。结果: 大鼠原位肝移植后,在Wistar-Wistar同基因移植组中,各时点均无明显的排斥反应表现,相应地肝组织内仅有微弱的IFN-γ mRNA表达,脾细胞没有明显的NFAT-DNA结合活性;SD-Wistar急性排斥组中,移植后3天即表现明显的排斥反应,肝组织内可以检测到明显IFN-γmRNA表达,NFAT-DNA结合活性明显增强。与急性排斥组比较,SD-Wistar移植加用CsA治疗后,排斥反应明显受抑制,肝组织IFN-γ mRNA的表达明显减低(P＜0.05),没有明显的NFAT-DNA结合活性。NFAT活性和IFN-γ基因转录水平两者呈显著的相关性(r＝0.781,P＜0.01)。结论: 原位肝移植后IFN-γ基因转录的变化,至少部分是由于NFAT-DNA结合活性改变所致。CsA可以抑制NFAT活化,进而抑制IFN-γ基因转录。     

Tacrolimus in cardiac transplantation

The availability of effective immunosuppressive agents has allowed cardiac transplantation to become an accepted treatment for patients with end-stage heart disease. In recent years, tacrolimus has emerged as a useful alternative to cyclosporine, combined with either azathioprine or the newer antiproliferative agents, mycophenolate mofetil or sirolimus. A number of randomized clinical trials have shown tacrolimus to be comparable with cyclosporine regarding survival and the drug also demonstrates equivalent or improved prophylaxis against acute rejection. The adverse effects of tacrolimus differ from cyclosporine and the drug demonstrates a particularly improved profile with respect to hypertension and dyslipidemia. These data have recently led to regulatory approval of tacrolimus for primary immunosuppression in cardiac transplantation in the USA.     

Immunosuppressive therapy post-transplantation in children: what the clinician needs to know

ABSTRACT

Introduction: The goal of immunosuppressive therapy post-transplantation in pediatric renal transplant recipients is to prevent acute and chronic rejection while minimizing drug side effects. Most therapies alter immune response mechanisms but are not immunologically specific, and a careful balance is required to find the dose that prevents rejection of the graft, while minimizing the risks of over-immunosuppression leading to infection and cancer.

Areas covered: This review article focuses on immunosuppressive therapy in pediatric renal transplant recipients, but many aspects can be applied on pediatric recipients of other solid organ transplants such as liver and heart. The major maintenance immunosuppressive agents currently used in various combination regimens are tacrolimus, cyclosporine, mycophenolate mofetil, azathioprine, everolimus, sirolimus, and glucocorticoids.

Expert opinion: Although data from adult renal transplantation trials are used to help guide management decisions in pediatric patients, immunosuppressive therapy in pediatric renal transplant recipients often must be modified because of the unique dosage requirements and clinical effects of these agents in children, including their impact on growth and development. The optimal immunosuppressive therapy post-transplant is not established. The goal remains to find the best combination of immunosuppressive agents that optimizes allograft survival by preventing acute rejection while limiting drug toxicities.     

Hepatotoxicity caused by both tacrolimus and cyclosporine after living donor liver transplantation.

We present a case report of a posttransplant patient who had hepatotoxicity due to both tacrolimus and cyclosporine and cholestatic jaundice due to tacrolimus. The patient did not show sustained improvement in enzyme and bilirubin abnormalities after an initial change from tacrolimus to cyclosporine or with a change back to tacrolimus, but he ultimately showed improvement when the blood concentration of tacrolimus was lowered. A 56-year-old man with subacute fulminant hepatitis induced by acarbose was admitted to our hospital for living donor liver transplantation. The liver graft consisted of the left lobe from his ABO-identical son. The early posttransplant course was uneventful. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin improved initially, but the ALT and AST levels later increased. A liver biopsy suggested a presumptive diagnosis of drug reaction. All drugs were discontinued, the immunosuppressive agent was changed from tacrolimus to cyclosporine. After initial improvement, the ALT and AST levels increased again. Assuming a reaction to cyclosporine, we decreased the concentration of cyclosporine in the blood. The enzyme levels improved temporarily but again began to rise. We changed the immunosuppressive agent to tacrolimus, which resulted in improvements in the ALT and AST levels; however, the total bilirubin level increased. We interpreted this increase as tacrolimus-induced cholestasis; in response, we decreased the blood concentration of tacrolimus to between 3 and 5 ng/dL and added 1,000 mg of mycophenolate mofetil to the drug regimen. The patient recovered without further complications. Repeated liver biopsies throughout the hospital course suggested that the mild mononuclear cell infiltration observed in a few triads had not been caused by acute rejection but had possibly been drug-induced.     

免疫抑制剂用于角膜移植排斥反应的临床应用评价

背景：角膜移植免疫排斥反应是一个复杂的反应过程,一般包括宿主对异体组织抗原的致敏和宿主对异体组织抗原的反应两方面。角膜移植失败的主要原因是免疫排斥反应,有效地防治角膜移植术后免疫排斥反应的发生是眼科治疗中亟待解决的实际问题. 目的：文章就目前有关免疫抑制剂在角膜移植免疫排斥反应中的应用作一数据分析。 方法：通过计算机检索Scopus数据库中2002/2011有关免疫抑制剂在角膜移植免疫排斥反应中的应用的文献,检索词为“角膜移植(keratoplasty/corneal transplantation);免疫排斥反应(immunological rejection);免疫抑制剂(immunosuppressant);环孢素A(cyclosporine A,CsA);他克莫司(tacrolimus)或 FK506;雷帕霉素(rapamycin,RAPA)”,共检索文献192篇。 结果与结论：免疫排斥反应的发生是多因素参与的复杂过程,尤其高度血管化的角膜、感染性角膜溃疡、重复移植等高危角膜病变,术后出现排斥反应的概率明显增加,排斥反应发生的时间也相对较早,而且时间跨度较长。角膜移植排斥反应是一个复杂的过程,其预防及治疗已取得了多方面的进展,但排斥反应仍是角膜移植失败的首要原因,所以,专家们在不断尝试应用新的药物和治疗措施改善角膜移植的存活率,其最终目标是使受体在保持正常免疫应答能力的情况下,诱导产生/建立供体特异性免疫耐受。免疫抑制剂在角膜移植排斥反应中的应用不可或缺。     

Long Term Management of Liver Transplant Rejection in Children

The current management of hepatic allograft rejection after liver transplantation in children requires effective baseline immunosuppression to prevent rejection and rapid diagnosis and treatment to manage acute rejection episodes. The subsequent impact on chronic rejection is dependent on the combination of adequate prevention and the treatment of acute rejection. Tacrolimus is a macrolide lactone that inhibits the signal transduction of interleukin-2 (IL-2) via calcineurin inhibition. Introduced in 1989, tacrolimus was first used in the salvage of refractory acute or chronic rejection under cyclosporin or to rescue patients with significant cyclosporin-related complications. The majority of paediatric transplant centres use a combination of steroids with tacrolimus as a basic immunosuppressant regimen following paediatric liver transplantation. This combination has allowed the acute cellular rejection-free rate to increase to between 30 and 60%, while lowering the rate of refractory rejection to less than 5%. Corticosteroid-resistant rejection is commonly treated with monoclonal (muromonab CD3) or polyclonal preparations. Although most episodes of acute cellular rejection occur during the first 6 weeks after liver transplant, the appearance of late acute liver allograft rejection must raise the question of noncompliance, especially in the adolescent population. Chronic rejection is becoming increasingly rare under tacrolimus-based immunosuppression. Tacrolimus is effective in reversing refractory acute cellular rejection or early chronic rejection in patients initially treated with cyclosporin-based regimens. Patients with a history of noncompliance as well as children with autoimmune liver disease are at risk of chronic rejection. Retransplantation therapy for chronic rejection has, fortunately, become more rare in the tacrolimus era with only 3% of retransplants being performed for this indication. Newer immunosuppressive agents are further modifying the long term management of liver allograft rejection. These include mycophenolate mofetil, rapamycin and IL-2 antibodies such as daclizumab. The development of these agents is allowing patient-specific immunosuppressive management to minimise rejection as well as the complications related to immunosuppression.     

活体肝移植中轻度脂肪变性供肝的应用

背景：在活体肝移植中使用脂肪变性供肝不但影响供者的安全,同时也影响受者的生存。 目的：评价活体肝移植中使用轻度脂肪变性供肝时供者的安全性及受者预后情况。 方法：回顾性分析104例成人间右半肝活体肝移植的资料,根据移植过程中供肝活检病理标本的脂肪变性程度将所有病例分成4个组。比较各组移植供受者移植后2周的肝体积增生率,分析104例成人间活体右半肝肝移植受者移植后死亡情况及原因。 结果与结论：4组病例在供受者移植后肝功能的恢复和受者后移植预后无明显差别,没有肝功能延迟恢复和原发无功发生。轻度大泡性脂肪肝者只要残肝足够可以成为合适的活体肝移植供者。使用轻度大泡性脂肪肝并不增加受者病死率和移植物失功。     

Tacrolimus in Heart Transplant Recipients

The development of cyclosporine was pivotal in allowing cardiac transplantation to become an accepted treatment for patients with end-stage heart disease. More recently, tacrolimus has become available as a useful alternative to cyclosporine, and has been successfully combined with either azathioprine or the newer anti-proliferative agents, mycophenolate mofetil or sirolimus. Numerous randomized clinical trials have demonstrated that tacrolimus is comparable to cyclosporine in terms of overall patient survival and at least equally effective in preventing acute rejection. In addition, tacrolimus has been particularly effective as a rescue treatment in cases where recurrent rejection has occurred with cyclosporine. The adverse effects of tacrolimus differ from those of cyclosporine, and the drug particularly shows an improved profile with respect to hypertension, dyslipidemia, and long-term renal function. These data have recently led to the regulatory approval of tacrolimus for primary immunosuppression in patients undergoing cardiac transplantation in the US.     

Filtering lymphocytes may decrease the need for immunosuppression in solid organ transplantation

Organ transplantation has become very important for patients with irreversible organ diseases. The transplanted organ is foreign to the host and, therefore, it induces a complex immune response of the patient. Therefore, Immunosuppressive agents are usually required to suppress both specific and nonspecific immunity and prevent allograft rejection in recipients who undergo organ transplantation. Of the late years, newer immunosuppressive agents with non-overlapping toxicities have been used in combinations in order to provide better patient and graft survival. However, these medications are associated with significant adverse effects that impact quality of life and sometimes long-term survival of the patient. Adverse effects can differ between the immunosuppressants, but many result from the overall state of immunosuppression. Strategies to manage immunosuppressant adverse effects often involve minimizing exposure to the drugs while balancing the risk for rejection. However, to prevent rejection of the transplanted organ, there may be unproven approaches other than immunosuppressive drugs. Filtering lymphocytes by a specific filter with respect to their size can be an alternative way. Our hypothesis was concerning of if such a filter could manage this and take the place of these drugs.     

肾移植后急性排斥反应及免疫抑制剂的应

背景：肾移植后急性排斥反应在临床较为常见,免疫抑制剂的出现促进和推动了肾移植质量的提高,免疫抑制剂的合理应用对肾移植患者至关重要,成为影响患者生存率的重要因素。 目的：对肾移植后急性排斥反应和免疫抑制剂研究文献进行多层次分析。 方法：以电子检索方式对Web of Science数据库2002至2011年收录肾移植后急性排斥反应和免疫抑制剂研究的文献进行分析,采用检索词为“肾移植;急性排斥反应;免疫抑制剂”。对肾移植后排斥反应进行分类,了解肾移植后免疫抑制剂的种类,分析各种免疫抑制剂的特点。 结果与结论：Web of Science数据库2002至2011年收录肾移植后急性排斥反应和免疫抑制剂研究的文献共6 105篇,文献数量总体呈现出逐步上升的发展状态,《移植学会会报》杂志是发表肾移植后急性排斥反应和免疫抑制剂研究文献较多的期刊。美国在此类研究中发表文献最多,其次为德国。收录文献按被引频次由高到低排序前10位中,有4篇来源于《新英格兰医学》杂志。中国在过去10年间被收录文章总量排在第9名,共发表238篇相关文献,中国的国家自然科学基金资助文献有17篇。