TY - JOUR
T1 - Sirolimus as the main immunosuppressant in the early postoperative period following liver transplantation
T2 - A report of six cases and review of the literature
AU - Vivarelli, Marco
AU - Vetrone, Gaetano
AU - Zanello, Matteo
AU - Barba, Giuliano La
AU - Cucchetti, Alessandro
AU - Lauro, Augusto
AU - Grazi, Gian Luca
AU - Pinna, Antonio Daniele
PY - 2006/12
Y1 - 2006/12
N2 - 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.
AB - 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.
KW - Immunosuppression
KW - Liver transplantation
UR - http://www.scopus.com/inward/record.url?scp=33750578442&partnerID=8YFLogxK
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U2 - 10.1111/j.1432-2277.2006.00381.x
DO - 10.1111/j.1432-2277.2006.00381.x
M3 - Article
C2 - 17081233
AN - SCOPUS:33750578442
VL - 19
SP - 1022
EP - 1025
JO - Transplant International
JF - Transplant International
SN - 0934-0874
IS - 12
ER -