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肾移植术后免疫抑制治疗是改善移植肾和肾移植受体生存率的重要手段,但目前常用的钙调神经蛋白抑制剂(CNI)、皮质激素等免疫抑制剂的个体化差异和不良反应严重影响了免疫抑制治疗的效果。针对这些问题,国内外研究者提出了CNI节减方案、激素撤减方案和CYP3A5基因多态性指导用药等肾移植术后免疫抑制治疗方案。CNI节减方案包括免用CNI方案、撤用CNI方案、换用CNI方案和减用CNI方案,常见以依维莫司、西罗莫司、贝拉西普替换CNI。改进肾移植术后免疫抑制治疗方案能够更好地保护移植肾并提高肾移植受体的生存率。
Immunosuppressive therapy after renal transplantation is an important means to improve the survival rate of recipients of allograft and kidney transplant recipients. However, individualized immunosuppressive agents such as calcineurin inhibitor (CNI) Affect the effect of immunosuppressive therapy. In response to these problems, researchers at home and abroad put forward immunosuppressive regimens after renal transplantation such as CNI reduction program, hormone withdrawal program and CYP3A5 gene polymorphism. CNI reduction programs include the free CNI program, the withdrawal of CNI program, switch to CNI program and CNI reduction program, with the usual with the everolimus, sirolimus, beacaterose replacement CNI. Improved immunosuppressive regimen after renal transplantation can better protect the graft kidney and improve the survival rate of renal transplant recipients.