Sirolimus in liver transplant recipients

A large single-center experience

M. Vivarelli, A. Dazzi, A. Cucchetti, A. Gasbarrini, M. Zanello, P. Di Gioia, G. Bianchi, M. R. Tam, M. D. Gaudio, M. Ravaioli, M. Cescon, G. L. Grazi, A. D. Pinna

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Sirolimus (SRL) is a newer immunosuppressant whose possible benefits and side effects in comparison to calcineurin inhibitors (CNIs) still have to be addressed in the liver transplantation setting. We report the results of the use of SRL in 86 liver transplant recipients, 38 of whom received SRL as the main immunosuppressant in a CNI-sparing regimen. Indications for the use of SRL were: impaired renal function (n = 32), CNI neurotoxicity (n = 16), hepatocellular carcinoma (HCC) at high risk of recurrence (n = 21), recurrence of HCC (n = 6), de novo malignancies (n = 4), cholangiocarcinoma (n = 1), and the need to reinforce immunosuppression (n = 6). Among patients on SRL-based treatment, four episodes of acute rejection were observed, three of which occurred during the first postoperative month. Renal function significantly improved when sirolimus was introduced within the third postoperative month, while no change was observed when it was introduced later. Neurological symptoms resolved completely in 14/16 patients. The 3-year recurrence-free survival of patients with HCC on SRL was 84%. Sixty-two patients developed side effects that required drug withdrawal in seven cases. There was a reduced prevalence of hypertension and new-onset diabetes among patients under SRL. In conclusion, SRL was an effective immunosuppressant even when used in a CNI-sparing regimen. It was beneficial for patients with recently developed renal dysfunction or neurological disorders.

Original languageEnglish
Pages (from-to)2579-2584
Number of pages6
JournalTransplantation Proceedings
Volume42
Issue number7
DOIs
Publication statusPublished - Sep 2010

Fingerprint

Sirolimus
Liver
Immunosuppressive Agents
Hepatocellular Carcinoma
Kidney
Recurrence
Transplant Recipients
Cholangiocarcinoma
Nervous System Diseases
Drug-Related Side Effects and Adverse Reactions
Liver Transplantation
Immunosuppression
Hypertension
Survival
Calcineurin Inhibitors

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Vivarelli, M., Dazzi, A., Cucchetti, A., Gasbarrini, A., Zanello, M., Di Gioia, P., ... Pinna, A. D. (2010). Sirolimus in liver transplant recipients: A large single-center experience. Transplantation Proceedings, 42(7), 2579-2584. https://doi.org/10.1016/j.transproceed.2010.04.045

Sirolimus in liver transplant recipients : A large single-center experience. / Vivarelli, M.; Dazzi, A.; Cucchetti, A.; Gasbarrini, A.; Zanello, M.; Di Gioia, P.; Bianchi, G.; Tam, M. R.; Gaudio, M. D.; Ravaioli, M.; Cescon, M.; Grazi, G. L.; Pinna, A. D.

In: Transplantation Proceedings, Vol. 42, No. 7, 09.2010, p. 2579-2584.

Research output: Contribution to journalArticle

Vivarelli, M, Dazzi, A, Cucchetti, A, Gasbarrini, A, Zanello, M, Di Gioia, P, Bianchi, G, Tam, MR, Gaudio, MD, Ravaioli, M, Cescon, M, Grazi, GL & Pinna, AD 2010, 'Sirolimus in liver transplant recipients: A large single-center experience', Transplantation Proceedings, vol. 42, no. 7, pp. 2579-2584. https://doi.org/10.1016/j.transproceed.2010.04.045
Vivarelli M, Dazzi A, Cucchetti A, Gasbarrini A, Zanello M, Di Gioia P et al. Sirolimus in liver transplant recipients: A large single-center experience. Transplantation Proceedings. 2010 Sep;42(7):2579-2584. https://doi.org/10.1016/j.transproceed.2010.04.045
Vivarelli, M. ; Dazzi, A. ; Cucchetti, A. ; Gasbarrini, A. ; Zanello, M. ; Di Gioia, P. ; Bianchi, G. ; Tam, M. R. ; Gaudio, M. D. ; Ravaioli, M. ; Cescon, M. ; Grazi, G. L. ; Pinna, A. D. / Sirolimus in liver transplant recipients : A large single-center experience. In: Transplantation Proceedings. 2010 ; Vol. 42, No. 7. pp. 2579-2584.
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