儿童肝移植受者围手术期CD25人源化单克隆抗体联合激素减量免疫诱导的疗效探讨OA北大核心

Objective To observe the efficacy of recombinant anti-cluster of differentiation 25(CD25)humanized monoclonal antibody plus steroid reduction immune induction regimen in preventing acute rejection(AR)in pediatric liver transplant(LT)recipients.Methods Retrospective analysis was conducted for 79 pediatric LT recipients between July 2015 and August 2024.Based upon perioperative immune induction regi-mens,they were assigned into two groups of full-dose steroid(n=60)and CD25 monoclonal antibody combined with half-dose steroid(n=19).The former group received full-dose steroid induction perioperatively,followed by tacrolimus plus steroids for postoperative immunosuppression.And the latter group received recombinant anti-CD25 humanized monoclonal antibody plus half-dose steroid induction perioperatively,followed by tacrolimus monotherapy for postoperative immunosuppression.The incidence rates of postoperative AR,infection,steroid-re-lated complications and other primary outcomes were compared between two groups.Secondary outcomes,inclu-ding intensive care unit(ICU)stay,graft survival,patient survival,length of hospitalization stay and hospitaliza-tion expenses were also compared.Results The incidence of AR(4/19 vs.16/60),infection complications(12/19 vs.40/60)and steroid-related complications(11/19 vs.24/60)in CD25 monoclonal antibody com-bined with half-dose steroid group did not significantly differ from full-dose steroid group(P＞0.05).Addition-ally,no significant inter-group differences existed in ICU stay[7.5(3.0,11.0)vs.3.5(0.0,12.0)d],hospi-talization expenses[18.99(13.13,41.45)vs.19.54(15.22,29.32)ten thousand yuan],graft survival rate(18/19 vs.59/60)or patient survival rate(19/19 vs.54/60)(P＞0.05).However,length of hospitalization stay was significantly shorter in CD25 monoclonal antibody combined with half-dose steroid group than that in full-dose steroid group[24.0(17.0,34.0)vs.35.0(27.0,46.5)day,P＜0.05].Conclusions The recom-binant anti-CD25 humanized monoclonal antibody plus steroid reduction immune induction regimen is both safe and effective,achieving similar immunosuppression with tapered steroid dosing.However,as compared with ster-oid group,it does not significantly lower the incidence of AR,infections or steroid-related complications.