关键词:

text-indent:0pt, vertical-align:middle, "> 胰肾联合移植术, 激素撤除, 安全性, 终末期糖尿病肾病

Abstract:

Objective To evaluate the clinical safety of the steroid withdrawal strategy in patients with endstage diabetic kidney disease（ESDN）after simultaneous pancreas-kidney transplantation（SPKT）. Methods A retrospective analysis was conducted on 81 ESDN patients who underwent SPKT at the Second Affiliated Hospital of Guangzhou Medical University from January 2020 to January 2022. The patients were divided into the early withdrawal group（discontinued within 3 months after surgery，n＝29），the non-early withdrawal group（discontinued between3 and 10 months after surgery，n = 22），and the steroid maintenance group（long-term low-dose maintenance， n＝30）. The functional indicators of the transplanted pancreas and kidneys，as well as the survival rates of the recipients and grafts，were compared among the different withdrawal strategies. The occurrence of postoperative complications was also analyzed. Results Within 1 year of follow-up，the survival rates of the recipients and their transplanted pancreas and kidneys were all 100%. The fasting blood glucose，glycosylated hemoglobin，and serumcreatinine levels at different time points after surgery showed a similar distribution，and there were no statistically significant differences among the groups. The incidence of various postoperative complications also showed no significant difference（P＞0.05）. Conclusion With the support of standardized immunization induction and maintenance of immunosuppressive regimens，the implementation of steroid withdrawal after SPKT in ESDN patients did not increase the short-term graft dysfunction，rejection reactions，or infection-related risks，suggesting that this strategy has good safety in the short-term follow-up.

Key words:

"> Simultaneous pancreas-kidney transplantation, Steroid withdrawal, Safety, End-stage diabetic nephropathy