Steroid withdrawal five days after renal transplantation allows for the prevention of wound-healing complications associated with sirolimus therapy

Clinical Transplantation
Silvio SandriniGiovanni Cancarini

Abstract

Sirolimus (SRL) can increase the risk of wound complications. In this study, we investigated the impact of steroids when added to SRL, in this side effect. One hundred and forty-eight patients entered prospective studies comparing early (fifth day) with late (sixth month) steroid withdrawal. All patients were on SRL, added either to Tacrolimus (n = 56) or to cyclosporine (n = 97). At 15th day after transplantation, 68 patients were on steroids (On-St group) and 80 were not (Off-St group). Wound complications considered were as follows: dehiscence, lymphocele, wound leakage, hematoma and seromas. Risk factors under analysis were as follows: body mass index, diabetes, rejection, creatininemia, length of dialysis before transplantation, recipient age, being on steroids at 15th day, SRL levels. The overall incidence of wound complications was significantly lower in Off-St group than in On-St group: 18.8% vs. 45.6%, respectively (p < 0.0004). In detail, lymphocele: 5.0% vs. 32.3% (p < 0.0001); dehiscence 0% vs. 10.3% (p < 0.009), leakage 6.2% vs. 8.8% (p = NS), seromas 1.4% vs. 7.5% (NS). At multivariate analysis, the addition of steroids to SRL increases 4.2-fold the risk for wound complications. Early steroid withdrawal is effecti...Continue Reading

References

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Citations

Jun 16, 2009·Expert Opinion on Drug Safety·Samir J PatelA Osama Gaber
Oct 1, 2011·Transplant International : Official Journal of the European Society for Organ Transplantation·Liset H M PengelPeter J Morris
Sep 29, 2015·Clinical Kidney Journal·Andrea RanghinoLuigi Biancone
Mar 16, 2017·Transplant International : Official Journal of the European Society for Organ Transplantation·André L MihaljevicArianeb Mehrabi
Sep 29, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Peter GirmanFrantišek Saudek
Aug 23, 2016·The Cochrane Database of Systematic Reviews·Maria C HallerAngela C Webster
Jul 17, 2021·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Emre KarakayaMehmet Haberal

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