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Nine cases of conversion from calcineurin inhibitor to sirolimus in the treatment of urological neoplasm in kidney allograft recipients
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF ORGAN TRANSPLANTATION
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.0254-1785.2007.04.005
- Key Word:
- 免疫抑制剂;肾移植;泌尿系肿瘤
Abstract： 目的 探讨肾移植术后发生泌尿系统肿瘤的患者采用西罗莫司(SRL)替代钙调磷酸酶抑制剂(CNI)的有效性及安全性.方法 将9例肾移植术后发生泌尿系统肿瘤患者的CNI转换为SRL.所有患者停用CNI 12 h后使用SRL,首次负荷剂量为3～4 mg,维持剂量为0.5～1.5 mg/d,以后根据SRL的血药浓度调整使用剂量.将SRL的血药浓度维持于:术后1年内6～10 μg/L,1～2年4～8 μg/L,2年以后3～6 μg/L.药物转换过程中,监测患者的肿瘤复发情况,观察移植肾功能及排斥反应,统计药物的不良反应及药物转换前、后治疗费用的变化.结果 9例患者经药物转换后有8例病情稳定,肿瘤复发率明显降低.仅有1例患者肿瘤复发,于药物转换后12个月死亡.所有患者肾功能保持稳定并有所改善,均无明显不良反应发生,治疗费用也较药物转换前有不同程度的下降.结论 肾移植后发生泌尿系统肿瘤的患者使用SRL是安全和有效的,同时也可减少治疗费用.
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