Rejection Episodes and 3-Year Graft Survival Under Sirolimus and Tacrolimus Treatment After Adult Intestinal Transplantation

A. Lauro, A. Dazzi, G. Ercolani, C. Zanfi, L. Golfieri, A. Amaduzzi, A. Cucchetti, G. La Barba, G. L. Grazi, A. D'Errico, M. Vivarelli, M. Cescon, G. Varotti, M. Del Gaudio, M. Ravaioli, M. Di Simone, S. Faenza, L. Pironi, A. D. Pinna

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Mammalian target of rapamycin (mTOR) inhibitors have been recently introduced in clinical practice after intestinal transplantation. We focused on Sirolimus (Rapamycin) to examine effects on rejection and graft survival following intestinal transplantation. Patients and methods: Twenty isolated intestinal recipients and 5 multivisceral patients (2 with liver) in our series were divided into 3 groups: patients started on Sirolimus (because of nephrotoxicity or biopsy-proven rejection), who continued therapy longer than 3 months (n = 11); patients started on Sirolimus (because of nephrotoxicity or biopsy-proven rejection), who received therapy less than 3 months because of side effects (n = 4); and a control group, who never received rapamycin (n = 10). Results: During prolonged treatment combined with Tacrolimus (Prograf), both Sirolimus groups showed a decreased number of acute cellular rejections (P <.01). Cumulative 3-year graft and patient survival rates were 81% in the Sirolimus greater than 3 months group, 100% in the Sirolimus less than 3 months group, and 80% and 90% in the control group, respectively (P = .63 and P = .62). Conclusion: In our experience, the use of mTOR-inhibitors in combination with calcineurin-inhibitors seemed to be more effective than monotherapy to reduce the number of rejections. Side effects can limit its use as maintenance therapy.

Original languageEnglish
Pages (from-to)1629-1631
Number of pages3
JournalTransplantation Proceedings
Volume39
Issue number5
DOIs
Publication statusPublished - Jun 2007

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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