Incidence of cardiovascular and cerebrovascular events associated with sirolimus use after liver transplantation

Transplantation Proceedings
A WeickD Moonka

Abstract

Sirolimus (SRL) is an immunosuppressant often used in liver transplantation (LT) to mitigate renal insufficiency associated with calcineurin inhibitors. Sirolimus can cause hyperlipidemia, but its association with coronary artery disease (CAD) and cerebrovascular accidents (CVAs) is unclear. The purpose of this study was to assess the risk of CAD and CVAs with the use of SRL in LT recipients. We retrospectively reviewed all of our LT recipients from 2000 to 2011. Patients with multiorgan transplant, multiple liver transplants, everolimus therapy, or survival <3 months were excluded. The 803 remaining patients were divided into 3 groups: 1) 134 patients who received and tolerated SRL; 2) 604 patients who never received SRL; and 3) 65 patients who started but discontinued SRL. The primary outcome was the development of CAD or CVA beyond 4 months after transplantation with the use of time-dependent Kaplan-Meier analysis. In group 1, there were 6 CAD and 2 CVA events; in group 2, 27 CAD and 16 CVA events; and in group 3, 10 CAD and 2 CVA events. The event-free survival for CAD/CVA at 1, 3, and 5 years was 100%, 98.1%, and 97.2% respectively for group 1; 99.7%, 98.4%, and 96.1% for group 2; and 92.3%, 92.3%, and 85.6% for group 3. O...Continue Reading

References

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Citations

Jun 9, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Carmen VinaixaMarina Berenguer
Jan 25, 2019·Current Opinion in Organ Transplantation·Manhal IzzyKymberly D Watt
Jan 31, 2016·Current Opinion in Organ Transplantation·Harmeet MalhiKymberly D Watt
Jul 14, 2017·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Lisa B VanWagnerDonald M Lloyd-Jones
May 25, 2016·World Journal of Gastroenterology : WJG·Seyed Soheil Saeedi SaraviAhmad Reza Dehpour
Jun 10, 2017·World Journal of Hepatology·Yolanda Sanchez-TorrijosManuel Romero-Gómez
Oct 27, 2020·Metabolic Syndrome and Related Disorders·Stefano GittoUNKNOWN MEDITRA Research Group

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