外科CHU, SHENG-HSIENSHENG-HSIENCHUCHIANG, YANG-JENYANG-JENCHIANGLEE, PO-HUANGPO-HUANGLEEHU, REY-HENGREY-HENGHULAI, MING-KUENMING-KUENLAICHUEH, SHIH-CHIEHSHIH-CHIEHCHUEHTSAI, MENG-KUNGMENG-KUNGTSAI2008-12-162018-07-112008-12-162018-07-112004http://ntur.lib.ntu.edu.tw//handle/246246/91968BACKGROUND: Acute rejection is a major cause of graft loss in renal transplantation. Because the highest risk for acute rejection is in the first month posttransplantation, improved prophylaxis could be most beneficial in this period . Simulect administration provides 30 to 45 days of immunoprophylaxis against acute rejection during the critical period after transplantation. OBJECTIVES: We sought to assess the incidence of acute rejection episodes and the safety and tolerability of Simulect plus Neoral immunosuppression. Patient and graft survival rates up to 3 years posttransplantation were evaluated. METHOD: Forty-one transplant recipients received Simulect by intravenous infusion of an initial 20-mg dose on the day of renal transplantation and a second 20-mg dose on day 4 posttransplant. All renal recipients received immunosuppression with Neoral and steroid. RESULTS: There were eight cases (19.5%) of acute rejection within 1 year. The rejection episodes were easily reversed with steroid pulse therapy in seven patients except for graft loss. The 1 -, 2- , and 3-year graft survival rates were 95%, 93%, and 88 %, respectively. Overall, the 3-year patient survival rate was 100%. CONCLUSIONS: Simulect in combination with Neoral and steroid-reduced the incidence of acute rejection without an increase in adverse events. The low incidence and severity of acute rejection may have led to the superior 3- year patient and graft survival rates in renal transplantation.en-USjournal article