他克莫司替代环孢素A在肾移植术后肝功能损害患者中的应用

目的 :评价对肾移植术后肝功能损害患者用他克莫司 (FK5 0 6 )替代环孢素A(CsA)治疗的有效性及安全性。方法 :2 3例肾移植术后肝功能损害患者由CsA加霉酚酸酯 (MMF)加泼尼松 (Pred)方案改为FK5 0 6加MMF加Pred方案。FK5 0 6按 0 .1mg/kg·d-1剂量口服 ,随后根据血药浓度调整用量。结果 :2 3例患者除 1例因肺部感染死亡外 ,其余均在替代用药后 6 0d内肝功能恢复正常。有 6例患者出现血糖升高 ,1例血脂升高。 6例血糖升高者有 4例既往有糖尿病史 ,1例并发丙型肝炎。结论 :FK5 0 6替代CsA治疗肾移植术后肝损害患者效果好 ,无排斥反应发生、安全

Application of FK506 substituting for cyclosporine (CsA) in renal transplant recipients with hepatic impairment

Purpose:To evaluate the efficacy and safety of FK506 instead of CsA in renal transplant recipient with hepatic impairment. Methods:Twenty three patients with hepatic impairment were treated with FK506 instead of CsA. The initial dose was adjusted to base on its blood trough levels and the degree of hepatic impairment. Results:By two months after using FK506, twenty-two of those patients got a normal hepatic function except one who died of infection of lung. Six have high blood sugar levels, four of which were diabetes , one with HCV before operation. One has a high blood cholesterol. Conclusions:FK506 is a potent immunosuppressive agent. In those hepatic impairment transplant recipients, Application of FK506 substituting for CsA can recover hepatic function with few side effects and safety and without rejective episodes.