Mayo 诊所的研究人员发现了新的心脏移殖患者之免疫抑制疗法，有助于改进他们的肾脏功能，并防止移植后发生冠状动脉疾病。
心脏移殖患者必需每天服用免疫抑制药物，以防止他们的身体排斥移植的器官。标准的治疗药物是calcineurin抑制剂。但是，calcineurin抑制剂会导致患者肾脏功能不良，而且无法防止移植后的冠状动脉疾病。
研究作者同时也是心脏科医师Sudhir Kushwaha表示。百分之10的患者接受移植后5到10年，就需要接受血液透析或肾脏移植。而且接受移植后10年，百分之50的患者会发生冠状动脉疾病或因此死亡。
研究人员利用一种名为sirolimus的抗增生免疫抑制药物，以对抗排斥反应。在第一项研究中，共包含78 名心脏移殖患者，从calcineurin抑制剂改以sirolimus治疗，结果发现他们的肾脏功能改善。没有发生移植的心脏排斥反应且心脏功能也无变化。第二项研究发现29 名患者改以sirolimus治疗后，移植后的冠状动脉疾病之发生率降低了。
Mayo诊所的研究人员将于4月26 日于旧金山举行的国际心脏及肺脏移植协会年会和科学会议中，提出他们的研究结果。
（编译/姜欣慧） (资料来源 : biocompare)
英文原文：
Mayo Clinic Study Finds Heart Transplant Patients Benefit From New Approach To Immunosuppression
4/26/2007
Source: Mayo Clinic
A new immunosuppression regimen for heart transplant patients can improve kidney function and prevent transplant coronary artery disease, according to two new Mayo Clinic studies. Mayo researchers will report their findings on April 26 at The International Society for Heart & Lung Transplantation Annual Meeting and Scientific Session in San Francisco.
Heart transplant patients are required to take daily immunosuppressive medication to prevent their body from rejecting the transplanted organ. Standard practice has been to treat patients primarily with calcineurin inhibitors. However, calcineurin inhibitors are a major cause of kidney dysfunction and do not prevent transplant coronary artery disease, a rapidly progressing coronary disease that develops in many heart transplant recipients and greatly limits long-term survival.
"Immunosuppression for heart transplant patients using calcineurin inhibitors has been essentially unchanged for 25 years, and the results have not been ideal," says Sudhir Kushwaha, M.D., the lead author and a cardiologist at Mayo Clinic. "Five to 10 years post-transplant, 10 percent of patients are on dialysis or need a kidney transplant. And 10 years post-transplant, 50 percent of patients are either waiting for another heart transplant because of coronary artery disease or have died as a result of it."
Dr. Kushwaha and a team of Mayo Clinic researchers collaborated to study alternative options for immunosuppression, using sirolimus, an anti-proliferative immunosuppression drug with potent anti-rejection properties.
One study involving 78 heart transplant patients over four years found that gradually transitioning stable patients from calcineurin inhibitors to sirolimus showed consistent improvement of kidney function. There was no increase in rejection of the transplanted heart and no difference in heart function.
A second study found gradual transition to sirolimus in 29 patients also greatly impaired the development of the proliferative changes found in transplant coronary artery disease.
"Based on our findings, patients should still receive calcineurin inhibitors as the primary immunosuppressant immediately after transplant, and the conversion to sirolimus must be gradual in order to prevent rejection," says Dr. Kushwaha. "Today, standard practice at Mayo Clinic is to consider converting all heart transplant patients from calcineurin inhibitors to sirolimus at six months post-transplant if there are no contraindications."
