PDF(Pubmed)
Abstract：
UNASSIGNED: In immunosuppression after transplantation, several multi-drug approaches are used, involving calcineurin inhibitors (CNI: tacrolimus-TAC or cyclosporine-CsA), antimetabolites (antiMs), mammalian target of rapamycin inhibitors (mTORis), and corticosteroids. However, data on immunosuppressive therapy by organ and its space-time variability are lacking.
UNASSIGNED: An Italian multicentre observational cohort study was conducted using health information systems. Patients with incident transplant during 2009-2019 and resident in four regions (Veneto, Lombardy, Lazio, and Sardinia) were enrolled. The post-transplant immunosuppressive regimen was evaluated by organ, region, and year.
UNASSIGNED: The most dispensed regimen was triple-drug therapy for the kidneys [tacrolimus (TAC) + antiM + corticosteroids = 41.5%] and heart [cyclosporin + antiM + corticosteroids = 36.6%] and double-drug therapy for liver recipients (TAC + corticosteroids = 35.4%). Several differences between regions and years emerged with regard to agents and the number of drugs used.
UNASSIGNED: A high heterogeneity in immunosuppressive therapy post-transplant was found. Further studies are needed in order to investigate the reasons for this variability and to evaluate the risk-benefit profile of treatment schemes adopted in clinical practice.
UNASSIGNED: An Italian multicentre observational cohort study was conducted using health information systems. Patients with incident transplant during 2009-2019 and resident in four regions (Veneto, Lombardy, Lazio, and Sardinia) were enrolled. The post-transplant immunosuppressive regimen was evaluated by organ, region, and year.
UNASSIGNED: The most dispensed regimen was triple-drug therapy for the kidneys [tacrolimus (TAC) + antiM + corticosteroids = 41.5%] and heart [cyclosporin + antiM + corticosteroids = 36.6%] and double-drug therapy for liver recipients (TAC + corticosteroids = 35.4%). Several differences between regions and years emerged with regard to agents and the number of drugs used.
UNASSIGNED: A high heterogeneity in immunosuppressive therapy post-transplant was found. Further studies are needed in order to investigate the reasons for this variability and to evaluate the risk-benefit profile of treatment schemes adopted in clinical practice.
摘要：
■在移植后的免疫抑制中，使用了几种多药物方法，涉及钙调磷酸酶抑制剂（CNI：他克莫司-TAC或环孢菌素-CsA），抗代谢药(抗代谢药)，哺乳动物雷帕霉素靶抑制剂（mTORis），和皮质类固醇。然而,缺乏有关器官免疫抑制治疗及其时空变异性的数据。
■使用健康信息系统进行了一项意大利多中心观察性队列研究。2009-2019年期间发生移植的患者，居住在四个地区(威尼托，伦巴第,拉齐奥,和撒丁岛）报名参加。移植后免疫抑制方案按器官进行评估，区域,和年份。
■最常用的方案是肾脏[他克莫司(TAC)+抗M+皮质类固醇=41.5%]和心脏[环孢菌素+抗M+皮质类固醇=36.6%]的三联药物治疗和肝脏受者的双联药物治疗(TAC+皮质类固醇=35.4%)。在药物和使用的药物数量方面，地区和年份之间出现了一些差异。
■发现移植后免疫抑制治疗存在高度异质性。需要进一步的研究，以调查这种变异性的原因，并评估在临床实践中采用的治疗方案的风险效益。
■使用健康信息系统进行了一项意大利多中心观察性队列研究。2009-2019年期间发生移植的患者，居住在四个地区(威尼托，伦巴第,拉齐奥,和撒丁岛）报名参加。移植后免疫抑制方案按器官进行评估，区域,和年份。
■最常用的方案是肾脏[他克莫司(TAC)+抗M+皮质类固醇=41.5%]和心脏[环孢菌素+抗M+皮质类固醇=36.6%]的三联药物治疗和肝脏受者的双联药物治疗(TAC+皮质类固醇=35.4%)。在药物和使用的药物数量方面，地区和年份之间出现了一些差异。
■发现移植后免疫抑制治疗存在高度异质性。需要进一步的研究，以调查这种变异性的原因，并评估在临床实践中采用的治疗方案的风险效益。
