雷帕霉素在肾移植后肝功能损害患者中的应用七例

目的探讨肾移植术后发生肝功能损害时使用雷帕霉素治疗的有效性和安全性。方法7例患者肾移植术后均采用以环孢素A(CsA)为基础的免疫抑制方案,发生肝功能损害后,除采取常规护肝治疗外,根据肝功能的受损程度,以雷帕霉素替代CsA,或加用雷帕霉素,同时CsA减量。结果肝功能损害的发生时间,3例为术后2~3周,4例为术后4~10个月。经过采取上述措施,6例肝功能恢复正常,1例死亡。迄今随访3~13个月,肝功能未再出现异常。6例患者在治疗及随访期间肾功能均正常,未发生急性排斥反应。结论肾移植术后发生肝功能损害时,使用雷帕霉素治疗是安全和有效的。

Application of rapamycin in the patients with liver injury following renal transplantation: a report of 7 cases

Objective To explore the efficiency and safety of rapamycin used for liver injury following renal transplantation. Methods In 7 cases, cylosporine A (CsA)-based immunosuppressive protocol was used after renal transplantation. After the liver function was injured, rapamycin substituting for CsA, or combined rapamycin with decreased dose of CsA was given according to the injury degree of liver function besides the routine hepatic protection therapy. Results The time of liver function injury was postoperative 2-3 weeks in 3 cases and 4-10 months in 4 cases respectively. The liver functions were returned to normal in 6 cases. One died. Up to date, 3-13 months follow-up showed that no abnormal liver functions occurred. During therapy and follow-up, the renal functions in 6 cases were all normal and on acute rejection occurred.Conclusion Rapamycin is same and effective in the treatment of liver injury following renal transplantation.