Belatacept对肝移植受者的补救性维持免疫抑制作用

Q4 Medicine
Kyle Lang , Clare Kane , Lisa B. VanWagner
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引用次数: 4

摘要

Belatacept是一种新型融合蛋白,可阻断T细胞激活的信号二。Belatacept于2015年被批准用于预防肾移植受者的急性排斥反应。2014年一项针对肝移植受者的II期临床试验结果因死亡和移植物损失风险增加而提前终止,导致该药物在肝移植受者中的使用出现黑框警告。在这里,我们描述了一个55岁的男性患者谁接受肝移植胆汁淤积性肝病的临床过程。他的移植后过程中出现了多次严重的急性细胞排斥反应,以及维护性免疫抑制的多种并发症,包括慢性肾病(CKD)、类固醇诱导的糖尿病、霉酚酸相关结肠炎和哺乳动物雷帕霉素靶点(mTOR)抑制剂诱导的肺损伤。移植后5年开始使用Belatacept作为维持免疫抑制的最后一线选择。开始治疗6个月后,患者CKD稳定,肺功能改善,无急性或慢性排斥反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Belatacept as salvage maintenance immunosuppression in a liver transplant recipient

Belatacept is a novel fusion protein that blocks signal two of T cell activation. Belatacept was approved in 2015 for the prevention of acute rejection in kidney transplant recipients. Results from a 2014 phase II clinical trial in liver transplant recipients was terminated early due to an increased risk of death and graft loss, leading to a black box warning for its use in liver transplant recipients. Here we describe the clinical course of a 55 year old male patient who underwent a liver transplant for cholestatic liver disease. His post-transplant course was complicated by multiple episodes of severe acute cellular rejection as well as multiple complications from maintenance immunosuppression including chronic kidney disease (CKD), steroid-induced diabetes, mycophenolate-associated colitis, and mammalian target of rapamycin (mTOR) inhibitor-induced lung injury. Belatacept was initiated 5 years post-transplant as a last-line option for maintenance immunosuppression. Six months post-initiation, the patient has had stabilization of his CKD, improvement in lung function, and remains without evidence of acute or chronic rejection.

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来源期刊
Transplantation Reports
Transplantation Reports Medicine-Transplantation
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
101 days
期刊介绍: To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI
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