在移植中比较两种子抗胸细胞球蛋白免疫抑制的非传染性不良影响:一个多中心的回顾性研究
Mojtaba Shafiekhani1,2, Ayda Esmaeili3, Fatemeh-Sadat Emami4,5
1Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Expert opinion on biological therapy
|May 29, 2025
概括
血栓栓塞栓事件 (TEEs) 发生在接受子抗血球蛋白 (rATG) 的4.9%的移植患者中. 没有肝素的外周rATG输液,CMV感染和接受者的年龄较大被确定为TEE的关键风险因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 临床药理学 临床药理学
背景情况:
- 抗胸细胞球蛋白 (rATG) 是移植中的标准诱导免疫抑制剂.
- 然而,rATG的使用与潜在的不良反应有关,包括血栓栓塞事件 (TEE).
研究的目的:
- 确定移植后TEE的发生率.
- 调查rATG的使用与TEE的发生之间的因果关系.
- 确定移植患者中与TEE相关的危险因素.
主要方法:
- 一项多中心的回顾性研究,涉及654名脏移植接受者.
- 患者接受了Thymoglobulin® (rATG-A) 或TGlobulin25TM (rATG-B) 的诱导疗法.
- 分析了包括移植后30天内TEE,血液学不良影响和移植结果在内的结果. 风险因素使用多变量回归来评估.
主要成果:
- TEE的总发病率为4.9%,rATG-A (4.0%) 和rATG-B (5.9%) 之间没有显著差异.
- TEE的独立风险因素包括无肝素的外周rATG输液,先前存在的血栓栓塞风险状况,细胞巨血病毒 (CMV) 感染和接受者年龄超过40岁.
- 两组之间在延迟移植功能,排斥,死亡率或腎切除率方面没有发现显著差异.
结论:
- TEEs影响大约5%的移植接受者接受rATG治疗.
- 没有肝素的外周rATG给药,潜在的血栓栓塞风险因素,CMV感染和接受者年龄>40岁是TEE的重要风险因素.
- 这些发现强调了高风险患者监测和预防策略的重要性.
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