中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (40): 7438-7443.doi: 10.3969/j.issn.2095-4344.2012.40.006

• 肾移植 kidney transplantation • 上一篇    下一篇

利妥昔单抗在肾移植后抗体介导排斥反应中的作用

刘天来，刘永光，李 民，郭 颖，李留洋，赵 明   

  1. 南方医科大学珠江医院器官移植中心，广东省广州市 510282
  • 收稿日期:2012-06-04 修回日期:2012-07-12 出版日期:2012-09-30 发布日期:2012-09-30
  • 通讯作者: 赵明，博士，博士生导师，主任医师，教授，南方医科大学珠江医院器官移植中心，广东省广州市 510282 zhaoming02@hotmail.com
  • 作者简介:刘天来★，男，1985年生，广东省台山市人，汉族，南方医科大学在读硕士，医师，主要从事移植免疫研究。 liutianlai0429@126.com

Clinical application of rituximab in antibody mediated rejection after renal transplantation

Liu Tian-lai, Liu Yong-guang, Li Min, Guo Ying, Li Liu-yang, Zhao Ming   

  1. Department of Organ Transplantation Center, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China
  • Received:2012-06-04 Revised:2012-07-12 Online:2012-09-30 Published:2012-09-30
  • Contact: Zhao Ming, Doctor, Doctoral supervisor, Chief physician, Professor, Department of Organ Transplantation Center, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China zhaoming02@hotmail.com
  • About author:Liu Tian-lai★, Studying for master’s degree, Physician, Department of Organ Transplantation Center, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China liutianlai0429@126.com

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摘要：

背景：国外研究表明，利妥昔单抗在肾移植后抗体介导的排斥反应中具有良好的安全性及有效性，但中国尚缺乏此类研究及报道。
目的：探讨利妥昔单抗在肾移植后抗体介导的排斥反应中的安全性和有效性。
方法：将肾移植后病理诊断为抗体介导的排斥反应的患者18例分为2组，均进行免疫抑制治疗，药物组8例采用单剂利妥昔单抗治疗；对照组10例不使用利妥昔单抗治疗。
结果与结论：用药后6，12个月，药物组肌酐水平均低于同期对照组(P < 0.05)。用药后随访6-12个月，药物组1例患者出现巨细胞病毒血症，1例患者出现泌尿系感染，随访期间无威胁生命的感染发生，人/肾存活率为100%。结果证实，利妥昔单抗在治疗肾移植移植后抗体介导的排斥反应中安全有效。

关键词: 利妥昔单抗, 肾移植, 抗体介导的排斥反应, 移植后免疫, 器官移植, 移植并发症, 移植后存活率

Abstract:

BACKGROUND: Foreign literatures show that the application of rituximab in antibody mediated rejection after renal transplantation has significant efficacy and good safety. But there still lacks of report and research of these in China.
OBJECTIVE: To investigate the efficacy and safety of rituximab in the treatment of antibody mediated rejection after renal transplantation.
METHODS: Eighteen patients who diagnosed with antibody mediated rejection after renal transplantation were divided into two groups, and all the patients in two groups received immunosuppressive therapy. Patients in the experimental group (n=8) received single dose rituximab treatment; patients in the control group (n=10) were treated without single dose rituximab treatment.
RESULTS AND CONCLUSION: After treated for 6 and 12 months, the creatinine level in the experimental group was lower than that in the control group (P < 0.05). After 6-12 months follow-up, in experimental group, one patient with cytomegaoviyns, one patient with urinary tract infection, no life-threatening infection during the follow-up period, and the patient/graft survival rate was 100%. It indicates that rituximab for the treatment of antibody mediated rejection after renal transplantation has significant efficacy and good safety.

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