Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: caso clínico pediátrico / Sirolimus for rescue of recurrent acute rejection and diabetes mellitus after liver transplantation: report of one case
Rev. méd. Chile
;
133(10): 1221-1224, oct. 2005.
Article
in Spanish
| LILACS
| ID: lil-420138
RESUMO
Sirolimus (SRL) is a new immunosuppressive drug approved for renal transplantation, but is being used increasingly in orthotopic liver transplantation (OLT). Compared with the calcineurin inhibitors, SRL has different mechanisms of action and side effects profile. Thus, this drug offers significant potential advantages over other immunosuppressive agents. SRL does not cause glucose intolerance, hypertension or renal failure, but it may cause dyslipidemia, hepatic artery thrombosis, thrombocytopenia, anemia, leukopenia, oral mucosa ulcers, edema, arthralgias and wound complications. SRL inhibits the signal of interleukin 2 at a post-receptor level, inhibiting lymphocyte proliferation and fibroblast proliferation. It also has antineoplastic and antifungal effects. We report a 10 years old girl who underwent OLT, experiencing a biopsy-proven recurrent acute rejection (AR) in spite of using three immunosuppressive agents (tacrolimus, mofetil micofenolate and steroids). She developed diabetes mellitus as a consequence of the immunosuppressive therapy. She was rescued with SRL, not experiencing AR again. Mofetil micofenolate, steroids and insulin could be discontinued and tacrolimus doses were reduced, without experiencing severe complications. SRL is a new and safe immunosuppressive agent for rescue in patients with OLT and recurrent AR.
Full text:
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Index:
LILACS (Americas)
Main subject:
Liver Transplantation
/
Sirolimus
/
Diabetes Mellitus
/
Graft Rejection
/
Immunosuppressive Agents
Limits:
Child
/
Female
/
Humans
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2005
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Clínica Alemana/CL
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