Safety and immunologic benefits of conversion to sirolimus in kidney transplant recipients with long-term exposure to calcineurin inhibitors
The Korean Journal of Internal Medicine
; : 552-559, 2016.
Article
en En
| WPRIM
| ID: wpr-48496
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND/AIMS:
Sirolimus (SRL) is a promising immunosuppressant replacingcalcineurin inhibitors (CNIs). This study was performed to evaluate the safetyand immunologic benefits of conversion to SRL in stable kidney transplant (KT)recipients exposed to CNIs for long periods.METHODS:
Fourteen CNI-treated KT recipients with stable renal function for morethan 10 years were included. Either 2 or 3 mg per day of SRL was administeredwhile CNIs were reduced by half starting on day 1, and then stopped 2 weeks afterSRL introduction. The safety of SRL conversion was assessed considering thegraft function, acute rejection, and graft loss. Immunologic alterations were measuredvia serial changes of T cell and B cell subsets after SRL conversion. Adverseeffects of SRL conversion were also evaluated.RESULTS:
Conversion to SRL was successful in nine patients (64.2%). Conversionto SRL preserved graft function as compared to the baseline value (p = 0.115). Noacute rejection or allograft loss was observed during the follow-up period. Immunemonitoring of T and B cells revealed a regulatory T cells increase after SRL conversion (p = 0.028). Most adverse events developed within 6 weeks after SRLconversion, and oral mucositis was the main cause of SRL withdrawal.CONCLUSIONS:
Conversion to SRL can be safe and has immunologic benefits in KTrecipients with long-term CNI exposure. Close monitoring of mucocutaneous adverseevents is, however, required in the early period after SRL conversion.Palabras clave
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Estomatitis
/
Trasplante
/
Linfocitos B
/
Estudios de Seguimiento
/
Subgrupos de Linfocitos B
/
Trasplante de Riñón
/
Linfocitos T Reguladores
/
Calcineurina
/
Trasplantes
/
Sirolimus
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
The Korean Journal of Internal Medicine
Año:
2016
Tipo del documento:
Article