肝移植能用雷帕鸣吗

(sirolimus) is a basic immunosuppressant with almost no nephrotoxicity. Compared with cyclosporine, sirolimus has an anti-angiogenic effect. It can indirectly produce anti-tumor effects by down-regulating VEGF and anti-angiogenic effects, and also has an inhibitory effect on upstream molecules with abnormal activity. Although the drug has been widely used in kidney transplant patients, the safety and therapeutic effectiveness of its use in liver transplant patients have not yet been determined. Therefore, at present, rapamin is not recommended for clinical use in such patients.

However, based on existing research experience, it is generally believed that the combination of SRL and low-dose calcineurin inhibitors (CNI) or hormones may achieve better results. After liver transplantation, rapamycin as an additive can reduce the required dose of CNI and reduce its neurotoxicity and nephrotoxicity. At the same time, combined use may inhibit the occurrence of AR.

Since Rapamin (sirolimus tablets) was approved by the FDA for clinical kidney transplantation in 1999, its application has attracted more and more attention. Compared with CNIs, the drug has almost no renal toxicity and can reduce or even replace the application of CNIs; sirolimus also has anti-cell proliferation and prevents microvascular fibrosis in the transplanted kidney, which can improve transplanted kidney function and delay chronic transplanted kidney failure; in addition, sirolimus also has anti-tumor effects, and the incidence of tumors in recipients using sirolimus is significantly lower than that using CNIs recipients; and the unique role of sirolimus in inducing peripheral immune tolerance after organ transplantation is a research hotspot at home and abroad.

A large number of experiments have confirmed that rapamycin can selectively expand CD4+CD25+FOXP3+ regulatory T cells in vitro and maintain its immunosuppressive ability. In vivo experiments have also confirmed that the proportion of regulatory T cells in the peripheral blood of kidney transplant recipients treated with cyclosporine was significantly reduced, while the regulatory T cells in recipients treated with rapamycin were not affected, suggesting that it can promote the induction and maintenance of immune tolerance after organ transplantation.

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