肾移植无CNI的免疫抑制方案

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Titlie：Calcineurin inhibitor-free immunosuppression in kidney transplantation.
标题：肾移植无CNI的免疫抑制方案肾移植无CNI的免疫
Author：Guerra G, Srinivas TR, Meier-Kriesche HU.
作者：Guerra G, Srinivas TR, Meier-Kriesche HU.
Source：Transpl Int. 2007 Jul 20; [Epub ahead of print]
文章来源：Transpl Int.2007年7月20日 [Epub ahead of print]
SUMMARY: The introduction of calcineurin inhibitors (CNI) revolutionized kidney transplantation (KTx).
摘要：CNI的应用带来肾移植预后的***性改变
Exceptionally low acute rejection rates and excellent graft survival could be achieved with CNI-based (cyclosporine and tacrolimus) immunosuppressive protocols.
以CNI（环孢霉素 A和他克莫司）为基础的免疫抑制方案，降低了急性排斥反应发生率，获得了很好的移植存活率
However, despite short-term success, long-term graft attrition continues to be a significant problem, thus leaving clinicians looking for possible interventions.
然而，虽然近期效果良好，但移植物长期存活仍然是未能解决的突出问题，因此需要医师需求可能的干预措施。
CNI nephrotoxicity is but one of numerous factors that may be contributing to long-term damage in transplant kidneys.
CNI肾毒性可能是影响移植肾长期生存众多损害因素之一
Therefore, newer immunosuppressive agents such as mycophenolate mofetil and sirolimus (Rapa) have raised the possibility of withdrawing or avoiding CNIs altogether.
因此，新的免疫抑制剂如：麦考酚酸吗乙酯和西罗莫司（雷帕霉素）的使用使CNI撤退或避免其使用的可行性上升。
CNIs Protocols exploring these options have gained greater attention over the last few years.
在过去几年里CNI撤退或无CNI的免疫抑制方案探索已经得到广泛的关注。
Herein, we review studies addressing either CNI withdrawal or CNI avoidance strategies as well as discuss the risks versus benefits of these protocols
在此，我们对CNI撤退或者无CNI的研究进行综述，并且讨论比较这个试验计划的缺点与优点
Given the accumulated experience to date, in our opinion, the use of CNIs as a part of immunosuppressive regimens remains the proven standard of care for renal transplant patients.
从目前累积的经验看，我们认为，CNIs作为免疫抑制措施的一部分，对于肾移植病人仍是标准选择。（仍可被认为是标准方案）
The long-term safety and efficacy of CNI withdrawal and avoidance strategies need to be further validated in controlled clinical trials.
CNI撤退或者无CNI策略，它的长期的安全与有效性，需要更多的临床对照试验来验证

[ 本帖最后由 urology_2008 于 2007-8-12 22:44 编辑 ]