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【文摘发布】肾移植无CNI的免疫抑制方案
Author：Guerra G, Srinivas TR, Meier-Kriesche HU.
Source：Transpl Int. 2007 Jul 20; [Epub ahead of print]
SUMMARY: The introduction of calcineurin inhibitors (CNI) revolutionized kidney transplantation (KTx). Exceptionally low acute rejection rates and excellent graft survival could be achieved with CNI-based (cyclosporine and tacrolimus) immunosuppressive protocols. However, despite short-term success, long-term graft attrition continues to be a significant problem, thus leaving clinicians looking for possible interventions. CNI nephrotoxicity is but one of numerous factors that may be contributing to long-term damage in transplant kidneys. Therefore, newer immunosuppressive agents such as mycophenolate mofetil and sirolimus (Rapa) have raised the possibility of withdrawing or avoiding CNIs altogether. Protocols exploring these options have gained greater attention over the last few years. Herein, we review studies addressing either CNI withdrawal or CNI avoidance strategies as well as discuss the risks versus benefits of these protocols. 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. The long-term safety and efficacy of CNI withdrawal and avoidance strategies need to be further validated in controlled clinical trials. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 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：由CNI介导的肾移植改革
Exceptionally low acute rejection rates and excellent graft survival could be achieved with CNI-based (cyclosporine and tacrolimus) immunosuppressive protocols.
实验通过CNI（环孢霉素 A和他克莫司<免疫抑制药>）依赖性免疫抑制剂能够获得特别低的急性细胞排斥率和特别理想的移植(术后)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，尽管获了短期的成功，但是长期的移植消耗仍然是一个重要的问题，因而通过非临床寻找合适介素
CNI nephrotoxicity is but one of numerous factors that may be contributing to long-term damage in transplant kidneys.
CNI肾毒性是可能造成肾移植长期损的众多害因素之外的另一个因素
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已经增加了降低或避免慢性神经刺激的可能性
Protocols exploring these options have gained greater attention over the last few years.
试验所探讨的这些选项已经得到了广泛的关注在过去几年里
Herein, we review studies addressing either CNI withdrawal or CNI avoidance strategies as well as discuss the risks versus benefits of these protocols试验计划.
在此，我们再一次研究CNI病理性退隐或者CNI避免策略，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，用CNIs作为部分免疫抑制剂的疗法保持统一的肾移植病人护理标准
The long-term safety and efficacy of CNI withdrawal and avoidance strategies need to be further validated in controlled clinical trials.
CNI病理性退隐或者CNI避免策略，它的长期的的安全与有效，需要更多的临床试验来验证
编译： 该翻译出入很大，请译者多斟酌斟酌。 编译：
标题：肾移植无CNI的免疫抑制方案
作者：Guerra G, Srinivas TR, Meier-Kriesche HU.
文章来源：Transpl Int.2007年7月20日 [Epub ahead of print]
摘要：通过CNI（环孢霉素 A和他克莫司<免疫抑制药>）依赖性免疫抑制试验能够获得极低的急性排斥率和理想的移植(术后)存活率，然而，尽管获了短期的成功，但是长期的移植摩擦仍然是一个显著的问题，因而临床医生仍然在寻找合适的干扰方法 ，CNI肾毒性很有可能也是造成肾移植长期损害的的众多害因素之一，因此，新的免疫抑制剂如：麦考酚酸吗乙酯和西罗莫司，总而言之已经增加了降低或无CNIs的可能性。试验所探讨的这些因素在过去几年里已经引起了更广泛的关注，从目前累积的经验看，我们认为，用CNIs作为部分免疫抑制剂的疗法，保持统一的肾移植病人护理标准，CNI病理性退隐或者无CNI策略的长期的的安全与有效，需要更多的临床试验来验证。 [quote SUMMARY: The introduction of calcineurin inhibitors (CNI) revolutionized kidney transplantation (KTx).
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作者:admin@医学,生命科学 2011-03-14 17:12
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