摘要
目的 总结肝移植术后免疫抑制剂个体化治疗经验.方法 回顾性分析32例肝移植患者免疫抑制剂使用与排斥反应防治情况,除外术后早期3例因非排斥反应原因死亡,共随访观察29例患者不同时期采用不同的免疫抑制方法的效果.结果 1例术后1年半自行停药,6个月后因免疫因素相关的慢性排斥死亡.术后1个月内轻微急性排斥反应3例,1例1个月后急性排斥反应,所有排斥反应均因药物浓度低或长时间停药造成,均早期发现,经加用FK506及激素后控制,现存活的11例中,CsA最低用量为2 mg/（kg·d）,FK506最低用量为0.02 mg/（kg·d）.结论 应根据受体免疫状态、术后不同时期、合并的特殊病情及对免疫抑制剂的个体差异等来决定免疫抑制剂方案及用量.
Objective To summarize the experience of individualized treatment with immunosuppressive agent after liver transplantation.Methods The immunosuppression protocol and rejection of 32 patients with liver transplantation were analyzed retrospectively.A total of 29 recipients were followed up to observe the effect of different immunosuppression protocols except 3 recipients who died for non-rejection factors during the early postoperative period.Results One recipient stopped all immunosuppressive agents by himself and died of chronic rejection after 6 months.There were 3 cases of mild acute rejection within 1 month after operation and 1 case of acute rejection after 1 month after operation.All rejections occurred because of low drug concentration or perennial immune agents withdrawal.These rejections were found timely and got control by using FK506 and steroid.In the 11 survival cases,the minimum amount of CsA was 2 mg/kg/d and the minimum amount of FK506 is 0.02 mg/kg/d.Conclusion The dosage and protocols of immunosuppressive agent depend on immune condition of receptor,different period after liver transplantation,concomitant complications and individual difference.
出处
《临床外科杂志》
2013年第8期600-602,共3页
Journal of Clinical Surgery
关键词
肝移植
免疫抑制治疗
个体化
liver transplantation
immunosuppression
individualized
