肾移植免疫诱导方案临床应用进展

随着免疫抑制剂的发展和免疫抑制方案的优化，肾移植受者和移植物的存活率显著提高，术后急性排斥反应发生率和移植物功能延迟恢复发生率也明显降低。但是标准的三联免疫抑制方案（钙调磷酸酶抑制剂+ 抗代谢药物+ 糖皮质激素）仍无法有效控制移植肾排斥反应，因此提出在移植前进行免疫诱导方案。免疫诱导治疗可推迟钙调磷酸酶抑制剂的应用时间，降低其使用剂量，减少术后短期急性排斥反应的发生，改善受者中远期预后。本文将从单克隆抗体为主的免疫诱导方案、多克隆抗体为主的免疫诱导方案以及间充质干细胞为主的免疫诱导方案进行探讨，以期为优化肾移植选择免疫诱导方案提供参考。

Clinical application progress of immune induction regimen for kidney transplantation

With the development of immunosuppressants and optimization of immunosuppressive regimens, the survival rates of kidney transplant recipients and grafts have been significantly increased, whereas the incidence of acute rejection and delayed graft function have also been significantly reduced. However, the standard triple immunosuppressive regimen (calcineurin inhibitor+antimetabolite+glucocorticoid) still cannot effectively control the rejection of transplant kidney. Consequently, immune induction before transplantation has been proposed. Immune induction therapy may delay the application time and reduce the dosage of calcineurin inhibitor, lower the incidence of short-term acute rejection after operation, and improve the middle- and long-term prognosis of the recipients. In this article, research progresses on monoclonal antibody-based immune induction regimen, polyclonal antibody-based immune induction regimen and mesenchymal stem cell-based immune induction regime were investigated, aiming to provide reference for optimizing the immune induction regime for kidney transplantation.