Quadruple low-dose immunosuppressant maintenance therapy protocol in renal transplanted recipients within three months after renal transplantation
10.3760/cma.j.cn421203-20191018-00377
- VernacularTitle:四联低剂量免疫抑制方案在肾移植术后早期应用研究
- Author:
Shuang FEI
1
;
Zijie WANG
;
Hao CHEN
;
Li SUN
;
Jun TAO
;
Zhijian HAN
;
Ruoyun TAN
;
Min GU
;
Xiaobing JU
Author Information
1. 南京医科大学第一附属医院泌尿外科 210029
- From:
Chinese Journal of Organ Transplantation
2020;41(3):174-179
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the efficacy and safety of quadruple low-dose immunosuppressant maintenance therapy of sirolimus(SRL), calcineurin inhibitors(CNIs), mycophenolate mofetil(MMF)and glucocorticoid in recipients switched within three months after renal transplantation.Methods:This retrospective study recruited 61 recipients on quadruple immunosuppressive therapy within three months after renal transplantation from 2013 to 2018. The changes of serum creatinine(SCr), blood urea nitrogen(BUN), hemoglobin(HGB), white blood cell(WBC), platelet(PLT), liver function, fasting blood-glucose(FBG), serum lipid, electrolyte and urine protein before and after using this protocol were recorded.Results:No significant difference existed between before and after protocol switching in WBC or serum sodium. But after protocol switching, significant differences could be observed in SCr, BUN, serum calcium, serum potassium, aspartate transaminase(AST), PLT, alanine transaminase(ALT), HGB, FBG, triglycerides(TG)and cholesterol(TC, P<0.05). Urine protein negative rate was 44.26 % before switching. However, it was 81.97 % after protocol switching. After switching during a 1-year follow-up period, the incidence of pulmonary infection rate was 24.59 %, the incidence of BKV infection rate 4.92 %, the incidence of transplant renal artery stenosis 3.28 % and the incidence of acute rejection 6.56 %. Conclusions:Quadruple low-dose immunosuppression maintenance therapy of SRL, CNIs, MMF and glucocorticoid switched within 3 months after renal transplantation may be an effective and safe protocol of improving renal allograft function and enhancing recipient prognosis.
