肝移植后采用巴利昔单抗进行免疫诱导治疗

目的 探讨肝移植后采用巴利昔单抗进行免疫诱导治疗预防急性排斥反应的有效性和安全性.方法 160例肝移植患者中,47例术后给予两剂巴利昔单抗(20 mg/剂)进行免疫诱导治疗(研究组),另外113例为对照组,不使用巴利昔单抗.所有患者术后均采用他克莫司、霉酚酸酯和糖皮质激素预防排斥反应.结果 术后1年内,研究组的急性排斥反应发生率为8.5%(4/47),对照组为22.1%(25/113),二者间的差异有统计学意义(P＜0.05);研究组排斥反应活动指数平均为4,对照组为6,两组间的差异无统计学意义(P＞0.05).研究组术后感染发生率为31.9 %(15/47),对照组为26.5%(30/113),两组间的差异无统计学意义(P＞0.05).研究组患者及移植肝1年存活率分别为95.7%和95.7%,对照组分别为96.5%和94.7%,两组间的差异均无统计学意义(P＞0.05).两组间其它不良反应发生率的差异也无统计学意义.结论 在以他克莫司为基础的免疫抑制治疗方案中,采用巴利昔单抗进行诱导治疗可明显降低肝移植后急性排斥反应发生率,且不增加感染和其它不良反应发生率.

Application of simulect in prevention of acute allograft rejection in liver transplantation recipients

Objective To explore the validity and security of simulect induction immunosuppressive therapy in terms of prevention for acute allograft rejection in liver transplantation. Methods 160 patients receiving liver transplantation in our center were analyzed retrospectively. There were 47 cases in the simulect group,and 113 cases in the control group, All of them received immunosuppressive therapy with FKS06, mycophenolate mofetil (MMF) and steroids as the basic treatment. Results The incidence of acute rejection was 8. 5 % in the simulect group and 22. 1 % in the control group respectively one year after operation with the difference being significant between two groups (P＜0. 05). The incidence of injection was 31.9 % and 26. 5 % in the simulect group and the control group respectively with the difference being not significant between two groups (P＞0. 05). There was no significant difference in incidence of other adverse reactions between two groups (P＞0. 05). Conclusion Simulect can significantly decrease the incidence of acute rejection in liver allograft recipients receiving FK506-based immunosuppressive regimen without increasing the incidence of infections and other adverse reactions.