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腎臓移植後の選択性サイクロスポリン離脱. メタアナリシスです
B L Kasiske1, K Heim-Duthoy, J Z Ma
1Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis 55415.
JAMA
|January 20, 1993
まとめ
腎臓移植後にサイクロスポリンを選択的に中止すると,急性拒絶率が増加しますが,短期的な移植または患者の生存には影響しません. シクロスポリン離脱の長期的な影響については,さらなる調査が必要である.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 免疫抑制は免疫を抑制する.
- 移植医療 移植医療について
背景:
- シクロスポリンは,腎臓移植後の重要な免疫抑制剤です.
- 免疫抑制薬の中止は望ましいが,リスクが伴う.
研究 の 目的:
- 腎臓移植後の選択性サイクロスポリン離脱療法の安全性と有効性を評価する.
- 急性拒絶,移植喪失,死亡率に対する影響を評価する.
主な方法:
- 統制試験の体系的なレビューとメタ解析.
- 関連する研究のためのMEDLINEと文献を検索しました.
- シクロスポリン離脱と継続/使用しないグループ間の比較結果.
主要な成果:
- シクロスポリンの離脱で観察された急性拒絶率の増加 (P < .001).
- 短期的な移植の喪失や死亡率に重大な違いはありません.
- ランダム化試験は,離脱後の移植の生存率の改善を示唆した (P = .049).
結論:
- 選択的サイクロスポリン離脱は急性拒絶を増加させるが,短期的な移植/患者の生存率は増加しない.
- サイクロスポリン離脱の長期的な結果は依然として不確実です.
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