早期转换为Everolimus 在活着的捐赠者肝移植180天内
Katelyn N Rudzik1, Kristine S Schonder2, Abhinav Humar3
1Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.
Clinical transplantation
|July 18, 2024
概括
在活体供体肝移植 (LDLT) 后早期转换为Everolimus (EVR) 时,没有增加排斥风险. 功能没有显著受到影响,这表明EVR是对氨酸抑制剂 (CNIs) 不耐受患者的可行替代品.
科学领域:
- 移植免疫学 移植免疫学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 早期Everolimus (EVR) 转换后已故供体肝移植与更好的功能,但更高的排斥率有关.
- 活体供体肝移植 (LDLT) 后早期EVR转换对排斥和功能的影响仍未评估.
研究的目的:
- 为了比较活检证明的急性排斥 (BPAR) 和在LDLT后早期转换为EVR的患者和维持氨尿素抑制剂 (CNI) 的患者之间的功能.
主要方法:
- 一个回顾性队列研究包括从2012年1月到2019年7月的成年LDLT接受者.
- 在180天内转换为EVR的患者与维持CNI的患者进行了比较.
- 主要终点:BPAR在24个月. 二级终点:eGFR,eGFR的变化,不良事件和死亡率.
主要成果:
- 在24个月后,BPAR没有显著差异 (22.7%的EVR与19.1%的CNI,p=0.63).
- 24个月的EGFR中位数相似 (68.6毫升/分钟EVR与75.9毫升/分钟CNI,p=0.103).
- 与基线相比,eGFR的变化在EVR组中更为严重 (p=0.047).
结论:
- 早期EVR转换后的LDLT与排斥增加无关.
- 整体而言,功能没有受到负面影响.
- 对于不耐受CNI的LDLT受体,EVR提出了一个潜在的替代性免疫抑制策略.
相关概念视频
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