雷帕霉素转换在肝移植术后肾功能不全患者中的应用

目的 总结肝移植术后患者出现钙调磷酸酶抑制剂(CNI)相关性性肾功能不全时,进行雷帕霉素(Rap)转换的临床效果.方法 回顾性分析中山大学附属第一医院从2004年1月到2008年6月间肝移植术后因肾功能不全而从CNI转向Rap治疗的病例.观察免疫抑制剂转换前后肾功能的变化,以及相关的副作用.结果 转换后4个月肾功能获得明显改善(P<0.05).转换后3个月血脂水平明显升高(P<0.05),但在控制范围内.结论 当肝移植术后患者出现CNI相关性肾功能不全时,Rap是一种安全有效的替代免疫抑制剂.

Abstract：

Objective To investigate the efficacy of conversion from calcineurin-inhibitor (CNI) to rapamycin in liver recipients with CNI-associated renal insufficiency. Methods This retrospective study examined the liver transplant recipients who had switched from CNI to rapamycin between January 2004 and June 2008 in the first affiliated hospital of Sun Yat-sen University. The data of renal function before and after the conversion were analyzed by Wilcoxon sum rank test, and rapamycin-related adverse effects were also observed. Results Compared with that before conversion, the renal funtion 4 months after the conversion improved significantly (P<0.05). The blood lipid level 3 months after the conversion increased significantly (P<0.05) but were well controlled. Conclusion Rapamycin can be used safely as a good alternative in liver transplant recipients with CNI-related renal insufficiency.

Conversion to rapamycin in liver transpant recipients with renal insufficiency

Objective To investigate the efficacy of conversion from calcineurin-inhibitor (CNI) to rapamycin in liver recipients with CNI-associated renal insufficiency. Methods This retrospective study examined the liver transplant recipients who had switched from CNI to rapamycin between January 2004 and June 2008 in the first affiliated hospital of Sun Yat-sen University. The data of renal function before and after the conversion were analyzed by Wilcoxon sum rank test, and rapamycin-related adverse effects were also observed. Results Compared with that before conversion, the renal funtion 4 months after the conversion improved significantly (P<0.05). The blood lipid level 3 months after the conversion increased significantly (P<0.05) but were well controlled. Conclusion Rapamycin can be used safely as a good alternative in liver transplant recipients with CNI-related renal insufficiency.