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目的探讨肾移植术后发生肝功能损害时使用雷帕霉素治疗的有效性和安全性。方法7例患者肾移植术后均采用以环孢素A(CsA)为基础的免疫抑制方案,发生肝功能损害后,除采取常规护肝治疗外,根据肝功能的受损程度,以雷帕霉素替代CsA,或加用雷帕霉素,同时CsA减量。结果肝功能损害的发生时间,3例为术后2~3周,4例为术后4~10个月。经过采取上述措施,6例肝功能恢复正常,1例死亡。迄今随访3~13个月,肝功能未再出现异常。6例患者在治疗及随访期间肾功能均正常,未发生急性排斥反应。结论肾移植术后发生肝功能损害时,使用雷帕霉素治疗是安全和有效的。
Objective To investigate the efficacy and safety of rapamycin in the treatment of liver dysfunction after renal transplantation. Methods All 7 patients received CsA-based immunosuppressive regimen after renal transplantation. After hepatic dysfunction, except for conventional liver protection, according to the damage degree of liver function, CsA instead of CsA, or rapamycin plus CsA at the same time. Results The incidence of liver dysfunction occurred in 3 cases 2 to 3 weeks after surgery and 4 cases 4 to 10 months after surgery. After taking the above measures, 6 cases of liver function returned to normal, 1 case died. So far, 3 to 13 months follow-up, no abnormal liver function. Six patients had normal renal function during treatment and follow-up, and no acute rejection occurred. Conclusion Rapamycin is safe and effective when liver damage occurs after renal transplantation.