肾移植术后以他克莫司及吗替麦考酚酯为基础的激素撤除方案的研究现状

Research Status of Steroid Withdrawal Regimens Based on Tacrolimus and Mycophenolate Mofetil after Kidney Transplantation

目的:探索激素撤除方案对成人肾移植受者的影响,致力于为临床决策提供参考。方法:充分检索近20年国内外以他克莫司及吗替麦考酚酯为基础的激素撤除免疫抑制维持方案的临床随机对照研究,评估激素撤除对肾移植受者的有效性及安全性。结果:大部分研究结果显示肾移植术后无激素或早期撤除激素对受者安全且有效,但各移植中心并未达成一致意见。结论:肾移植术后撤除激素利大于弊,但仍需充分评估患者具体情况,制定个体化的免疫抑制维持方案。

Objective: To explore the effect of steroid withdrawal on adult renal transplant recipients, in a bid to provide reference for clinical decision-making. Methods: We fully searched the clinical random-ized controlled studies of steroid withdrawal immunosuppression maintenance regimens based on tacrolimus and mycophenolate mofetil in the past 20 years at home and abroad to evaluate the ef-fectiveness and safety of steroid withdrawal in adult renal transplant recipients. Results: Most of the research results show that steroid-free or early steroid withdrawal after kidney transplantation is safe and effective for recipients, but the transplantation centers have not reached an agreement. Conclusions: The advantages of steroid withdrawal after kidney transplantation outweigh the dis-advantages, but it is still necessary to fully evaluate the specific situation of recipients and formu-late individualized immunosuppression maintenance regimen.