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Evidence for the Immunosuppressive Potential of Calcineurin Inhibitor-Sparing Regimens in Liver Transplant Recipients with Impaired Renal Function

机译:肾功能受损的肝癌抑制剂抑制剂抑制剂中免疫抑制潜力的证据

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摘要

Patients requiring liver transplantation (LT) frequently experience renal insufficiency (RI), which affects their survival. Although calcineurin inhibitor-sparing immunosuppressive regimens (CSRs) are well known to prevent RI, the immune state in recipients receiving CSR remains to be intensively investigated. Among 60 cases of living-donor LT at our institute, 68% of the patients had none to mild RI (non-RI group) and 32% of the patients had moderate to severe RI (RI group). The RI group received a CSR comprising reduced dose of tacrolimus, methylprednisolone, and mycophenolate mofetil, while the non-RI group received a regimen comprising conventional dose of tacrolimus and methylprednisolone. One year after LT, the mean estimated glomerular filtration rate (eGFR) in the RI group had significantly improved, although it was still lower than that of the non-RI group. Serial mixed lymphocyte reaction assays revealed that antidonor T-cell responses were adequately suppressed in both groups. Thus, we provide evidence that CSR leads to improvement of eGFR after LT in patients with RI, while maintaining an appropriate immunosuppressive state.
机译:需要肝移植(LT)的患者经常经历肾功能不全(RI),这会影响其存活率。虽然煅烧素抑制剂抑制剂抑制剂免疫抑制方案(CSRS)是众所周知的,但是接受CSR接受CSR的受者中的免疫状态仍有密集地研究。在我们学院的60例患者捐助者中,68%的患者对温和的RI(非RI组)没有,32%的患者患者中度至重度ri(RI组)。 RI组接受了CSR,其包含减少的Tacrolimus,甲基份醇酮和霉酚酸酯MofeTil,而非Ri基团得到包含常规剂量的躯体和甲基己酮醇的方案。在LT之后一年,RI组的平均估计肾小球过滤速率(EGFR)显着改善,尽管它仍然低于非RI组的估计。连续混合淋巴细胞反应测定显示,在两个基团中抑制反酮T细胞应答。因此,我们提供了证据表明,CSR导致在RI患者患者中改善EGFR,同时保持适当的免疫抑制状态。

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