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RENAL TRANSPLANT HASTALARIND A PULSE METİLPREDNİZOLON TEDAVİSİ İLE İMMÜNSÜPRESYON İNDÜKSİYONU

BOLUS METHYLPREDNISOLONE AS INDUCTION THERAPY FOR IMMUNOSUPPRESSION IN RENAL TRANSPLANT RECIPIENTS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Studies to prevent organ rejection in renal transplant patients are continuing. Improvement in HLA-matching and efficiency of immunosuppressive drugs are the most important factors. In this study, effects of single or three consecutive high dose (pulse) methylprednisolone therapy on acute rejection frequency in renal transplant recipients were investigated. Total of 30 patients were included in the study. There were 18 patients in the first group (10 M, 8 F, mean age 29.6±6.5) and single dose of 15 mg/kg methylprednisolone iv was given during the renal transplantation operation to these patients. The second group included 12 patients (8M, 4 F, mean age 31.2±7.9) and 15 mg/kg methylprednisolone iv was given during the renal transplantation operation and the same daily dose repeated next two days. Following high dose iv methylprednisolone treatment, prednisolone administration switched to oral route and dose reduced from 2.5-3 mg/kg to 20 mg/day in all patients in ten days. Other immunosuppressive drugs were cyclosporin-A (8 mg/kg bid) and 2.5-3 mg/kg azathioprine in all patients. Two groups were compared for delayed graft function, acute rejection episode, acute tubular necrosis and infection frequency which developed during the post transplant 6 months follow up period. There were no statistically important difference for delayed graft function, acute tubular necrosis and infection between two groups. However frequency of acute rejection attack was higher in the first group ( 44% versus 8%, p<0.05). Our results suggest that, use of three days high dose i.v. methyl prednisolone may be an alternative to decreases acute rejection frequency in renal transplant recipients.
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Abstract (Original Language): 
Renal transplantasyon yapılan hastalarda organ rejeksiyonımu önlemeye yönelik çalışmalar devam etmektedir. Hem doku grubu uygunluğunun artırılması hem de immünsüpresyonun etkinliği rejeksiyon ataklarım önlemede en önemli faktörlerdir. Bu çalışmada, renal transplantasyon yapılan hastalarda tek doz ve üç gün ardışık yüksek doz metilprednizolon verilmesinin akut rejeksiyon sıklığına etkisi araştırıldı. Çalışmaya toplam 33 renal transplantasyon hastası dahil edildi. Birinci gruptaki 18 hastaya (10 E, 8 K, ortalama yaş 29.6±6.5) operasyon esnasında 15mg/kg metilprednizolon i.v. olarak verildi, daha sonraki günlerde ise prednizolon dozu oral olarak 2.5-3 mg/ gün başlanarak, günlük azaltmalarla 20 mg/güne kadar inildi. İkinci gruptaki 12 hastaya ise (8E, 4 K, ortalama yaş 31.2±7.9) operasyon esnasında 15mg/kg metilprednizolon i.v. olarak verildi, sonra iki gün daha aynı doz tekrar edildi ve üçüncü doz metilprednizolondan sonra steroid dozuna ilk gruba benzer şekilde devam edildi. Her iki grupta siklosporin-A (8 mg/kg oral) ve azathioprine (2.5-3 mg/kg oral) aynı şekilde kullanıldı. Heriki grup posttransplant ilk 6 aylık takiplerinde ortay çıkan, gecikmiş renal fonksiyon, akut rejeksiyon, akut tubuler nekroz ve infeksiyon bakımından karşılaştırıldı. İki grup arasında gecikmiş renal fonksiyon, akut tubuler nekroz ve infeksiyon sıklığı bakımından önemli bir farklılık yok iken akut rejeksiyon sıklığı birinci grupta anlamlı olarak daha fazlaydı (%44'e %8, p<0.05). Bu çalışmanın sonuçları, 3 günlük yüksek doz metilprednizolonun akut rejeksiyon sıklığını azaltabilen bir indüksiyon tedavisi olabileceğini göstermektedir.
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  • 2
116-120
  • Turkish

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