肾移植术后感染与免疫抑制治疗

doi:10.5246/jcps.2026.05.033

中国药学(英文版) ›› 2026, Vol. 35 ›› Issue (5): 467-480.DOI: 10.5246/jcps.2026.05.033

肾移植术后感染与免疫抑制治疗

林硕¹^,²^,^#, 陈晶晶³^,^#, 鞠建杰³, 袁忠勇¹, 王周华¹^,^*()

^1. 福建医科大学附属闽东医院，福建宁德 355000
^2. 福建医科大学，福建福州 350122
^3. 福建医科大学药学院，福建福州 350122

收稿日期:2026-02-10 修回日期:2026-03-11 接受日期:2026-03-29 出版日期:2026-05-31 发布日期:2026-05-31
通讯作者: 王周华

Infections and immunosuppressive management in kidney transplantation

Shuo Lin¹^,²^,^#, Jingjing Chen³^,^#, Jianjie Ju³, Zhongyong Yuan¹, Zhouhua Wang¹^,^*()

^1. Mindong Hospital Affiliated to Fujian Medical University, Ningde 355000, Fujian, China
^2. Fujian Medical University, Fuzhou 350122, Fujian, China
^3. School of Pharmacy, Fujian Medical University, Fuzhou 350122, Fujian, China

Received:2026-02-10 Revised:2026-03-11 Accepted:2026-03-29 Online:2026-05-31 Published:2026-05-31
Contact: Zhouhua Wang
About author:
^# Shuo Lin and Jingjing Chen have contributed equally to this study and are co-first authors.
Supported by:
The Startup Fund for Scientific Research, Fujian Medical University (Grant No. 2019QH1217), and the Fujian Provincial Health Commission Scientific Research Plan Project (Grant No. 2021QNA076).

摘要/Abstract

摘要：

感染仍是肾移植受者发病、死亡及移植物功能障碍的重要原因，而免疫抑制策略在决定受者对传统及新发病原体的易感性方面持续发挥关键作用。随着病毒流行病学格局的变化、SARS-CoV-2的出现以及个体化免疫抑制策略的重要性不断提升，临床管理日益复杂，相关研究因此迅速增长。为系统梳理该领域的研究进展，本研究采用文献计量学方法，对过去15年全球肾移植感染管理与免疫抑制策略的研究格局进行了系统分析。研究共纳入Web of Science核心合集中的2568篇英文文献，利用CiteSpace 6.3.R1、VOSviewer 1.6.11及R的bibliometrix包对发文趋势、国家与机构贡献、合作网络及研究主题演化进行评估。结果显示，研究产出逐年增长，涉及98个国家，其中美国发文量最高(1019篇)，其后依次为德国、法国、中国和意大利。机构与作者合作网络呈现出稳定且长期的协作关系。关键词共现分析识别出100个高频关键词，分为六个聚类；时间演化分析显示研究重点已由早期的BK多瘤病毒、巨细胞病毒及免疫抑制毒性，逐步转向免疫监测、生物标志物开发、个体化免疫调控以及COVID-19相关并发症等新兴领域。这些发现展示了肾移植感染与免疫抑制管理领域全球研究格局的演进，并强调加强跨区域合作、拓展真实世界证据及基于病毒学与免疫学指标的精准免疫调控的重要性。

关键词: 肾移植, 感染管理, 免疫抑制治疗, BK多瘤病毒, 巨细胞病毒

Abstract:

Infections remain a leading cause of morbidity, mortality, and allograft dysfunction in kidney transplant recipients, with immunosuppressive management continuing to shape susceptibility to both traditional and emerging pathogens. Increasing clinical complexity, including shifts in viral epidemiology, the global emergence of SARS-CoV-2, and a growing emphasis on individualized immunosuppression, has accelerated research activity in this domain. To contextualize these developments, this bibliometric study systematically mapped global research on infection management and immunosuppressive strategies in kidney transplantation over the past 15 years. A total of 2568 English-language publications indexed in the Web of Science Core Collection (WOSCC) were analyzed using CiteSpace 6.3.R1, VOSviewer 1.6.11, and the bibliometrix package to assess publication trajectories, geographic and institutional contributions, collaboration networks, and thematic evolution. Research output increased steadily and spanned 98 countries, with the United States producing the highest number of publications (1019 articles), followed by Germany, France, China, and Italy. Institutional and author collaboration networks demonstrated durable, long-standing partnerships. Keyword co-occurrence analysis identified 100 high-frequency terms clustered into six thematic groups, while temporal mapping revealed a shift from earlier focus areas, such as BK polyomavirus (BKPyV), cytomegalovirus (CMV), and immunosuppressive toxicity, toward more recent interests in immune monitoring, biomarker discovery, individualized immunosuppression, and COVID-19–related complications. Collectively, these findings delineated the evolving global research landscape and underscored the need for strengthened cross-regional collaboration, expanded real-world evidence, and precision immunomodulation guided by virologic and immunologic profiling.

Key words: Kidney transplantation, Infection management, Immunosuppressive therapy, BK polyomavirus, Cytomegalovirus

Supporting:

林硕, 陈晶晶, 鞠建杰, 袁忠勇, 王周华. 肾移植术后感染与免疫抑制治疗[J]. 中国药学(英文版), 2026, 35(5): 467-480.

Shuo Lin, Jingjing Chen, Jianjie Ju, Zhongyong Yuan, Zhouhua Wang. Infections and immunosuppressive management in kidney transplantation[J]. Journal of Chinese Pharmaceutical Sciences, 2026, 35(5): 467-480.

图/表 10

Table 1. Search strategy for WOSCC.

Figure 1. Flowchart of the literature retrieval process.

Figure 2. Annual publication counts and citation frequencies from 2011 to 2025.

Figure 3. Country-level analysis of research output on kidney transplant infection and immunosuppressive therapy. (A) Overlay visualization of the top 50 most productive countries/regions generated using VOSviewer. Node size represents publication volume, and node color reflects the average publication year. (B) Distribution of countries contributing to this research field.

Figure 4. Overlay visualization of institutions (≥ 25 publications) contributing to research on kidney transplant infection and immunosuppressive therapy.

Table 2. Leading institutions in kidney transplant infection and immunosuppressive therapy research ranked by publication volume and citation counts.

Figure 5. Overlay visualization of author collaboration networks in kidney transplantation–related infection and immunosuppressive therapy research.

Table 3. Top 10 most prolific authors.

Table 4. Top 12 journals with the highest publication output.

Figure 6. Keyword analysis of infections and immunosuppressive management in kidney transplantation. (A) Keyword co-occurrence network; node size reflects keyword frequency. (B) Top 25 keywords with citation bursts (2011–2025). Blue bars indicate the observation period, and red bars represent the burst duration. (C) Temporal distribution of high-frequency keywords.

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肾移植术后感染与免疫抑制治疗

Infections and immunosuppressive management in kidney transplantation

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