Efficacy and safety of initial-dose mizoribine plus tacrolimus and corticosteroids in living-related renal transplant recipients

Longshan Liu, Jun Li, Q. Fu, Jiajia Jiang, Huanxi Zhang, R. Deng, Chenglin Wu, J. Fei, S. Deng, Guodong Chen, Gang Huang, J. Qiu, Lizhong Chen
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Abstract

Objective To assess the efficacy and safety of mizoribine (MZR) in initial immunosuppression in living-related renal transplant recipients. Methods From October 2015 to October 2017, twenty-two patients undergoing initial living-related renal transplantation received MZR (3-4 mg/kg/d) plus tacrolimus and corticosteroid. During a follow-up period of 12 months, patient/graft survival, incidence of acute rejection and adverse events were observed. Results There was no onset of graft loss and death and acute rejection rate was 22.7%. Renal allograft function remained stable. The incidence rate of cytomegaloviral infection was 4.5% and no CMV disease occurred. The incidence of BKV viruria was 36.4% and the infection rate was 18.2%. Digestive symptoms occurred (n=3, 13.6%). The major side effect of hyperuricemia could be controlled without reduction or withdrawal of MZR. Conclusions Excellent graft survival can be achieved when using MZR as initial immunosuppression in living-donor renal transplant recipients, yet the incidence of acute rejection remains high. Further study is required for determining the effect of MZR in the prevention of BK viral infection during renal transplantation. Key words: Kidney transplantation; Mizoribine; Acute rejection
初始剂量米佐瑞滨联合他克莫司和皮质类固醇在活体肾移植受者中的疗效和安全性
目的评价米索拉滨(mizoribine, MZR)对活体肾移植受者初始免疫抑制的疗效和安全性。方法2015年10月至2017年10月,22例首次活体肾移植患者接受MZR (3-4 mg/kg/d)联合他克莫司和皮质类固醇治疗。在12个月的随访期间,观察患者/移植物存活率,急性排斥反应发生率和不良事件。结果全组无移植物丢失和死亡,急性排斥反应发生率为22.7%。移植肾功能保持稳定。巨细胞病毒感染发生率为4.5%,未发生巨细胞病毒疾病。BKV病毒感染率为36.4%,感染率为18.2%。出现消化系统症状(n=3, 13.6%)。高尿酸血症的主要副作用可以在不减少或停用MZR的情况下得到控制。结论MZR作为活体肾移植受者的初始免疫抑制剂可获得良好的移植成活率,但急性排斥反应的发生率仍然很高。MZR在肾移植中预防BK病毒感染的作用有待进一步研究。关键词:肾移植;Mizoribine;急性排斥反应
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