Regression of Kaposi's sarcoma in renal graft recipients after conversion to sirolimus treatment.

摘要: Abstract Kaposi's sarcoma (KS) is a rare complication of renal transplantation in Poland (in our center 2 1000 patients). Neovascularization (typical for KS) promoted by KS-related vascular endothelial growth factor (t-r-VEGF). Sirolimus may reduce t-r-VEGF synthesis and inhibit PI3K-p70S6 kinase cells. Two men, 58 51 years old, were transplantated 2002. Initial immunosuppression consisted cyclosporine, azathioprine, prednisone. In the second patient, at week 8 was switched to tacrolimus mycophenolate mophetil. KS symptoms appeared on hard palate skin month 7 both patients. first X-ray showed enlargement mediastinal lymph nodes diffuse interstital infiltrates with nodular changes lungs. Serum creatinine patient increased from 1.6 1.9 mg/dL, while it remained stable (∼2.0 mg/dL). Since confirmation has been minimized patients; all drugs except prednisone withdrawn, sirolimus introduced (1–2 mg/24 hours blood level 5–8 ng/mL). Within progression lung disease ceased, patients' conditions began improve opacities regressing, biggest lesions diminishing smaller ones disappearing. 1 year function improved. Our observation suggests that sirolimus-based proffers possibility regression concomitant preservation among graft recipients. It difficult ascertain whether be atributted treatment or reduced overall immunosuppression.