Sirolimus monotherapy effectiveness in liver transplant recipients with renal dysfunction due to calcineurin inhibitors.

摘要: Introduction: Among the adverse effects of different calcineurin inhibitors (CIs), nephrotoxicity is most common (incidence: 18.1 % at 13 y from liver transplantation) and depends on a variable degree tubular-interstitial injury accompanied by focal glomerular sclerosis. A new immunosuppressive drug was introduced in solid organ transplant management, Sirolimus (SRL). It non-nephrotoxic immunosuppressor. Methods: Twenty-six patients who developed owing to CIs, showing an increment serum creatinine levels ( > 1.8 mg/dL) were switched SRL monotherapy, initially dosage between 3 5 mg/d, subsequently adapted achieve trough level 8 10ng/mL. Results: Patients followed-up for mean period 40.3 months (range, 8.4 76.7) transplantation. Mean follow-up after switch 27.5 2 71.2). Immunosuppression therapy converted 12.8 0.2 43.4). Serum creatinine, urea, estimated filtration rate significantly improved. Discussion: developing renal dysfunction transplantation may be successfully treated conversion CI SRL. Hypertriglyceridemia hypercholesterolemia represent principal side SRL, but are treatable. Furthermore, can improve glucose tolerance.