ABSTRACT
OBJECTIVE To com pare the long-term efficacy and safety betwe en domestic Mycophenolate mofetil dispersible tablets（dt-MMF）and imported Mycophenolate mofetil capsules （c-MMF）in kidney transplant recipients. METHODS In retrospective cohort study ，the data of patients who had undergone the living donor kidney transplantat during the period of 2012 to 2014 in West China Hospital of Sichuan University were screened and included ，and then divided into dt-MMF group and c-MMF group according to the drug use of kidney transplant recipients. Initial oral dose of dt-MMF and c-MMF were both 1 000 mg each time ， twice a day ；at the same time ，both groups were additionally given Tacrolimus capsules 1.5 mg，twice a day+Prednisone acetate tablets 5-10 mg，orally after breakfast every day. The clinical data of the two groups were collected before and after kidney transplant for 5 years；the efficacy and safety indexes of two drugs were compared ，and the robustness of results were analyzed by 1∶1 propensity score matching （PSM）. RESULTS A total of 666 kidney transplant recipients were included ，involving 316 patients in dt-MMF group and 350 patients in c-MMF group. The 5-year patient survival rates of dt-MMF group and c-MMF group were 99.68％ and 99.43％，the 5-year graft survival rates were 96.20％ and 94.29％，the acute rejection rates were 3.80％ and 6.57％，the 5-year chronic rejection rates were 2.22％ and 2.86％，and the incidences of delayed recovery of transplanted renal function were 0.63％ and 0.29％，respectively；there was no statistical significance （P＞0.05）. There were no significant differences in the incidence of major adverse events between 2 groups，including infection ，adverse events of the blood system and diges tive system （P＞0.05）. PSM analysis indicated the efficacy and safety results were robust （except for acute rejection ）. CONCLUSIONS There is no significant difference in clinical efficacy and safety between dt-MMF and c-MMF for immunosuppression after kidney transplant.
ABSTRACT
ABSTRACT Human cytomegalovirus (HCMV) infection is the main cause of morbidity in kidney transplant recipients. This study aims to investigate if CD64 expression on polymorphonuclear (PMN) cells is useful for the detection of HCMV infection in eleven kidney recipients during sixty days. From the total patients, nine were positive for both pp65 antigenemia and HCMV by quantitative polymerase chain reaction (qPCR), all of which had circulating neutrophils expressing CD64 3-4 weeks prior to pp65 antigenemia peak. These results suggest that quantification of PMN CD64 together with pp65 antigenemia could be useful for the early diagnosis of HCMV after transplantation.
RESUMO A infecção por citomegalovírus humano (CMVH) é a principal causa de morbidade em receptores de transplante renal. Este estudo pretende investigar se a expressão de CD64 em polimorfonucleares (PMN) é útil para a detecção de infecção por CMVH em 11 receptores renais durante 60 dias. Do total de pacientes, nove foram positivos para antigenemia pp65 e para CMVH por reação em cadeia da polimerase quantitativa (qPCR), todos apresentando neutrófilos circulantes que expressam CD64 3-4 semanas antes do pico de antigenemia pp65. Esses resultados sugerem que a quantificação de PMN CD64 em conjunto com a antigenemia pp65 pode ser útil para o diagnóstico precoce de HCMV no pós-transplante.