Sirolimus immunosuppression in pediatric heart transplant recipients: A single-center experience

摘要: Background Sirolimus has been used in heart transplant recipients for treatment of rejection, alternative immunosuppression (IS) and promotion regression prevention graft vasculopathy (coronary artery disease [CAD]). This study reports on our center's experience with 16 children who underwent transplantation. Methods Data were obtained by retrospective review. Results Median age at time review was 12.3 years ( n = 16, 5.1 to 18.0 years; 9 boys, 7 girls), 7.5 (6 months years). sirolimus introduction 2.7 (1 month 8.2 years) post-transplant. Fifteen patients steroids, 10 tacrolimus (FK) mycophenolate mofetil (MMF), 5 FK 1 MMF no calcineurin inhibitors (CNIs). The average dose 0.25 mg/kg or 7.0 mg/m 2 maintain a target level 15 μg/liter. started CAD 6 (38%), rejection (31%), combinations CNI intolerance, CAD, renal dysfunction rejection. All received (International Society Heart Lung Transplantation [ISHLT] Grade 3A) showed improvement follow-up biopsies. Two 3 (glomerular filtration rate [GFR] 43 67 32 106 ml/min per 1.73 m , respectively). Side effects included hyperlipidemia abdominal pain mouth ulcers (26%), anemia neutropenia (12.5%), persistent pericardial effusion (6%) interstitial lung (6%). therapy discontinued due side effects. Conclusions In this found be valuable IS agent the management significant These results support need prospective studies role primary prophylaxis, prophylaxis regression. There also exists establish an adverse event profile drug.