Clinical utility of combined administration of rapamycin and low dose of cyciosporin a in kidney transplantation recipients
- VernacularTitle:肾移植受者同时服用西罗莫司与低剂量环孢素A免疫抑制方案的探讨
- Author:
Zhengbin LIN
;
Sheng CHANG
;
Gang CHEN
- Publication Type:Journal Article
- Keywords:
Sirolimus;
Cyclosporin A;
Kidney transplantation;
Immunosuppression
- From:Chinese Journal of Organ Transplantation
2008;29(4):218-221
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and value of combined administration of rapamycin and low dose of cyclosporin A in kidney transplantation recipients. Methods Twenty-five recipients who received their kidney transplantations for 2 months to 10 years were transferred to a new immunosuppression regimen of combined administration of rapamycin,low dose of cyclosporin A and prednisone. During the clinical observation,the average serum trough level of cyclosporin A was maintained between 0.042 and 0.083 μmol/L,and the average serum trough level of rapamycin was controled to 4～8 μg/L. Meanwhile, the dosage of immunosuppressive drugs was adjusted properly according to the white blood cells counting,liver function,blood lipid level and clinical settings.Twenty-five kidney transplant recipients with usual immunosuppression regimen of cyclosporin A in combination with MMF and prednisone served as controls. Results Druing a follow-up period of 2 to 8 months,no acute rejection events were found in this group. All the recipients survived well with functional renal grafts. Two patients in the experimental group quitted during the follow-up. One was incurred to serious pulmonary infection diagnosed as cytomegalovirus infection,and another was sufferred from persistent unknown fever. Other main adverse effects included leucopenia, hyperlipemia and dental ulcer,similarly as control group. No significant abnormal liver function event was found in this group. Conclusions This new immunosuppression regimen of combined administration of rapamycin,low dose cyclosporin A and prednisone in kidney transplantation recipients could avoid or diminish the adverse and toxic effects of calcineurin inhibitors,mainlain well-functional allografts and not increase the incidence of severe untoward reactions. Meanwhile,the costs for taking medicine were also significantly reduced with this regimen. Therefore,it would be an ideal and optimal immunosuppressive maintainence regimen.
