Intestinal transplantation before and after the introduction of sirolimus.

摘要: INTRODUCTION Small bowel transplantation has been limited by high rates of rejection and graft loss. In June 2000, we began using sirolimus, an immunosuppression agent with proven efficacy in kidney transplantation. We reviewed results among intestinal transplant recipients before after the introduction sirolimus. METHODS Thirty-one transplants were performed 29 patients at our center between July 1998 April 2001. All followed for least 30 days posttransplant. first 19 (group 1), received tacrolimus, steroids, antibody induction therapy (either daclizumab or OKT3). next 12 consecutive 2), basiliximab, RESULTS Eighteen children (7 males 11 females, mean age 2.1+/-2.2 years) adults (9 2 38.1+/-12.4 underwent survived The overall reoperation rate was 1.7 procedures per patient group 1 1.1 2. most common indications abscess (n=7), planned second look leaks/fistulas (n=6), dehiscence obstruction (n=4), ischemic (n=3), perforations stomal complications removal (n=3). incidence biopsy-proven 73.7% 16.7% (P<0.002). Sirolimus temporarily held discontinued 66.7% patients. Actuarial 1-year survival 91.7% sirolimus 57.9% without (P<0.04). 79% (P=0.12). CONCLUSIONS An immunosuppressive regimen that includes improved survival. Furthermore, this significantly decreased early eliminated loss caused fulminant rejection.