UNIGE document Scientific Article
previous document  unige:35077  next document
add to browser collection

Conversion to sirolimus-based immunosuppression in maintenance liver transplantation patients

Dumortier, Jérôme
Published in Liver transplantation. 2007, vol. 13, no. 5, p. 658-64
Abstract Sirolimus (SRL) has been proposed to replace calcineurin inhibitors (CNI) in case of CNI-induced toxicity. The aim of this study was to evaluate the efficacy and safety of conversion from CNI to SRL in maintenance liver transplantation (LT) patients. Between 2002 and 2006, conversion was performed in 48 patients (17 female, 31 male; mean age 57 +/- 10 yr) after a median delay of 19.4 months (range 0.2-173 months) after LT. Indication for conversion was renal impairment (RI) (78%), CNI neurotoxicity (13%), or post-LT cancer (9%). Median follow-up was 22.6 +/- 11 months. Median SRL dosage and trough levels were 2.4 +/- 1.3 mg and 8.1 +/- 2.7 microg/L. Immunosuppression consisted of SRL alone (33%), or SRL + mycophenolate mofetil (MMF) (39%), SRL + prednisone (15%), SRL + CNI (4%), or SRL + MMF + prednisone (8%). Mean glomerular filtration rate (GFR) improved from 33 to 48 mL/minute in patients with severe RI (P = 0.022) and from 56 to 74 mL/minute in patients with moderate RI (P = 0.0001). After conversion, main complications were albuminuria (36%), hyperlipidemia (49%), dermatitis (14%), edema (14%), oral ulcers (12%), joint pain (4%), infection (2%), and pneumonia (2%). Acute rejection (AR) occurred in 17% of the patients. SRL was withdrawn in 17% of the patients. In conclusion, conversion from CNI to SRL is safe and is associated with significant renal function improvement.
Keywords AgedCalcineurin/antagonists & inhibitorsFeasibility StudiesFemaleFollow-Up StudiesGlomerular Filtration Rate/drug effectsHumansImmunosuppressive Agents/adverse effects/therapeutic useKidney/drug effects/physiopathologyLiver Transplantation/adverse effectsMaleMiddle AgedNeoplasms/etiologyNervous System Diseases/chemically inducedPostoperative CareRetreatmentSirolimus/adverse effects/therapeutic useTreatment Outcome
PMID: 17457887
Full text
Article (Published version) (215 Kb) - public document Free access
Research groups Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
Hépatologie chirurgicale (327)
(ISO format)
MORARD, Isabelle et al. Conversion to sirolimus-based immunosuppression in maintenance liver transplantation patients. In: Liver transplantation, 2007, vol. 13, n° 5, p. 658-64. doi: 10.1002/lt.21116 https://archive-ouverte.unige.ch/unige:35077

657 hits



Deposited on : 2014-03-28

Export document
Format :
Citation style :