长期耐受性和肺移植中对功能的影响:单中心体验
Ashley A Feist1, Mark Mariski2, Linda Awdishu1
1Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California.
Transplantation proceedings
|October 27, 2023
概括
肺移植后转换为西洛斯可以改善脏功能,而不会影响肺功能. 这种免疫抑制剂是减少氨酸抑制剂并发症的可行选择.
科学领域:
- 免疫抑制和移植
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肺部病理学 肺部病理学
背景情况:
- 肺移植接受者通常面临氨尿素抑制剂 (CNI) 毒性和支气管炎消灭症综合征.
- 研究西洛作为一种替代性免疫抑制剂对于治疗移植后并发症至关重要.
研究的目的:
- 评估转换肺移植接受者的长期疗效和安全性,转换为基于西罗的免疫抑制疗法.
- 为了比较西洛利木斯治疗患者与维持塔克罗利木斯治疗患者之间的和肺功能.
主要方法:
- 肺移植患者的回顾性队列研究 (2003-2016).
- 转换为西罗利木斯的患者与接受标准塔克罗利木斯治疗方案的患者的比较.
- 分析功能 (eGFR),肺功能,以及与西洛素相关的不良事件.
主要成果:
- 86%的患者转换为西罗,主要是由于功能障碍或CNI神经毒性.
- 转换西罗利木斯导致在移植后1年和3年估计的膜过率 (eGFR) 持续改善.
- 在1年和3年间,西罗和塔克罗群体之间没有观察到肺功能显著差异.
结论:
- 西洛利木斯是肺移植后可行的免疫抑制剂选择,可减少或取消CNI.
- 转换为西洛斯会导致功能持续改善.
- 西洛利斯提供了一种潜在的策略,以减轻肺移植接受者的CNI诱导的毒性.
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