肾移植后稳定期用FK好，还是雷帕鸣好？

To treat the disease, you must choose an appropriate method. Organ transplantation is a good organ to replace a damaged or functional organ, but patients should pay close attention to postoperative rejection. The generic name is sirolimus tablets. So, is it better to use FK or rapamycin (sirolimus) in the stable period after kidney transplantation?

Rapamin (sirolimus) is suitable for patients undergoing kidney transplantation. It is recommended to be used in combination with cyclosporine and corticosteroids to prevent organ rejection. Rapamin (sirolimus) mode of action: Sirolimus inhibits the activation and proliferation of T lymphocytes stimulated by antigens and cytokines (interleukins IL-2, IL-4 and IL-15). It also inhibits the production of antibodies. In cells, sirolimus binds to the immunophilin, FK-binding protein-12 (FKBP-12), to generate the FKBP-12 immunosuppressive complex. This complex binds to the mammalian sirolimus BA molecule (mTOR, a key regulatory kinase) and inhibits its activity, thereby inhibiting the progression from the G1 phase to the S phase in the cell cycle.

Rapamin (sirolimus) oral solution is rapidly absorbed after administration, with the average time to peak after a single oral dose being approximately 1 hour; in kidney transplant recipients, the average time to peak after multiple oral doses is approximately 2 hours. High-fat meals can increase the absorption of sirolimus, so it is recommended that oral rapamycin (sirolimus) should be taken regularly with or without food.

To explore the clinical efficacy and safety of rapamycin (sirolimus) in renal transplantation. Methods A total of 23 cadaveric kidney transplant patients from our hospital were given triple immunosuppressive therapy with this product combined with cyclosporine and glucocorticoids. Start taking this product within 48 hours after transplantation, with a loading dose of 6 mg and a maintenance dose of 2 mg.

Results: 22 patients completed 6-12 months of follow-up. The incidence rates of acute rejection (AR) at 6 and 12 months were 13.6% (3 cases/22 cases) and 15.8% (3 cases/19 cases) respectively. AR patients were reversed after methylprednisolone pulse treatment and continued to be followed up for more than half a year. No recurrence of AR was found. The main adverse reaction was hyperlipidemia (56.5%, 13 cases/23 cases). After reducing the dosage of this product or applying lipid-lowering drugs, the patient's blood lipids dropped to normal or slightly higher than normal levels. Graft vascular disease and cardiovascular complications have not increased since follow-up.

Conclusion (Sirolimus) combined with cyclosporine and glucocorticoids can reduce the incidence of AR after renal transplantation, and its long-term efficacy requires further observation and research.

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