Sirolimus as the main immunosuppressant in the early postoperative period following liver transplantation: A report of six cases and review of the literature

Marco Vivarelli, Gaetano Vetrone, Matteo Zanello, Giuliano La Barba, Alessandro Cucchetti, Augusto Lauro, Gian Luca Grazi, Antonio Daniele Pinna

Research output: Contribution to journalArticlepeer-review

Abstract

The use of sirolimus as the main immunosuppressant in a calcineurin inhibitor-free regimen in the early postoperative period of liver transplantation (LT), when the incidence of rejection is the highest, has seldom been reported. We report six patients who received sirolimus in association with steroids only, at a median time of 10 days after LT (range 3-23). Tacrolimus, initially given as the standard immunosuppressant, was discontinued because of nephrotoxicity in three of these patients and neurotoxicity in the other three. Resolution of the neurological symptoms was observed in all cases and a marked improvement of the renal function in two of three patients. Two patients died, one of sepsis and the other of recurrent hepatitis C virus hepatitis, after 47 and 143 days respectively. Three patients developed acute rejection which responded to intravenous steroids. In this cohort of patients, the use of sirolimus appeared safe and provided an adequate prophylaxis against rejection, even though the drug was administered in the immediate postoperative period after LT.

Original languageEnglish
Pages (from-to)1022-1025
Number of pages4
JournalTransplant International
Volume19
Issue number12
DOIs
Publication statusPublished - Dec 2006

Keywords

  • Immunosuppression
  • Liver transplantation

ASJC Scopus subject areas

  • Transplantation

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