个体化免疫抑制方案在肝移植高危受者中的应用

Individual immunosuppression regime in liver transplant recipients with high risk factors

目的 评价高危受者肝移植后采用个体化免疫抑制方案的意义。方法 根据受者术前情况的不同制定不同的免疫抑制方案 ,比较采用个体化免疫抑制方案的高危受者与采用常规免疫抑制方案的高危受者和普通受者肝移植术后肾功能衰竭、急性排斥反应、感染发生率 (包括细菌、真菌、巨细胞病毒感染 )以及院内死亡率。结果 采用个体化免疫抑制方案的高危受者肝移植术后肾功能衰竭、细菌及真菌感染的发生率以及院内死亡率均较采用常规免疫抑制方案的高危受者显著降低 (P<0 .0 5) ,与采用常规免疫抑制方案的普通受者相比 ,两个组上述指标的差异无显著性。结论 采用个体化免疫抑制方案较常规免疫抑制方案有更高的安全性 ,可以提高高危受者的肝移植成功率。

Objective To evaluate the significance of individual immunosuppression regime in liver transplant recipients with high risk factors. Methods Every liver transplant recipient received different immunosuppression regime based on different clinical conditions. Renal failure, acute rejection, bacterial, fungal and cytomegaloviral infection rate and hospital mortality were compared among the high risk recipients ( n =20) with individual immunosuppression regime, high risk recipients ( n =22) with routine immunosuppression regime and common recipients ( n =26) with routine regime. Results Renal failure, bacterial, fungal infection rate and hospital mortality were significantly different between high risk patients with individual immunosuppression regime and those with routine immunosuppression regime ( P < 0.05 ). There was no significant difference in acute rejection and cytomegaloviral infection rate between two groups ( P > 0.05 ). There was no significant difference in the above observed parameters between high risk recipients with individual immunosuppression regime and common recipients with routine regime ( P > 0.05 ). Conclusion Individual immunosuppression regime can prolong the survival of the recipients with high risk factors and is proved to be more safe and reliable.