在ABO不兼容的移植中使用类固醇:戒断与维持
Dong Hui Shin1, Ji Teak Kim2, Sung Hwa Kim3
1Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, South Korea.
Annals of transplantation
|July 29, 2025
概括
在ABO不兼容的接受者中,移植后的类固醇取消并没有增加排斥率或影响移植功能. 这一发现支持在ABO不兼容移植患者中探索类固醇最小化.
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
- 免疫抑制是一种免疫抑制.
背景情况:
- 增加了ABO-不兼容 (ABO-i) 移植 (KT) 的发生率.
- ABO-i KT 的早期死亡率更高,通常与广泛的免疫抑制有关.
- 降低类固醇使用在ABO兼容的KT中很常见,但在ABO-iKT中不太常见.
研究的目的:
- 为了研究类固醇戒断对ABO不兼容脏移植接受者的移植存活率的影响.
主要方法:
- 对接受ABO-i KT的33名患者的回顾性评估.
- 主要结局:通过活检证明了急性排斥.
- 二次结果:移植功能,感染,NODAT和延迟的移植功能.
主要成果:
- 类固醇维持 (30.8%) 和戒断 (40.0%) 组之间的3年活检证明的排斥率没有显著差异 (HR,1.11;P=0.648).
- 移植功能,感染率,NODAT和其他并发症在各组之间是相似的.
- 与维护相比,类固醇戒断并没有对结果产生负面影响.
结论:
- 戒除类固醇是ABO不兼容脏移植的安全选择.
- 与类固醇维护相比,它不会影响移植的生存或功能.
- 在ABO-i KT协议中降低类固醇的潜力.
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