Switch from calcineurin inhibitors to sirolimus-induced renal recovery in heart transplant recipients in the midterm follow-up

Transplantation
Reinaldo BestettiDaniel Villafanha

Abstract

Calcineurin inhibitor (CI)-based immunosuppression has prolonged the survival of heart transplant recipients. However, CI-induced renal injury remains as a major problem in these patients. Sirolimus is an immunosuppressant with no significant impact on renal function. A limited number of recent papers have showed that the switch from CI to sirolimus improved renal function in late follow-up of heart transplant patients with CI-related nephrotoxicity. Ten heart transplant recipients with CI-induced nephrotoxicity (creatinine 3.9+/-1.8 mg/dl) at a median of 701 (465 to 1325) days posttransplant had CI switched to sirolimus (target though levels 10 to 14 ng/ml) while mycophenolate mofetil (MMF, 3g/day) was maintained and adjusted according to white blood cell count. This maneuver caused a marked decrease in serum creatinine (P<0.00001) at 30 (1.2+/-0.4 mg/dl), 90 (1.3+/-0.4 mg/dl) and 180 (1.3+/-0.4 mg/dl) days post-conversion and a significant decrease in serum potassium levels (5.1+/-0.5 at baseline vs. 3.9+/-0.3 at 180 days, P<0.00005). After the drugs switch no changes in hemoglobin levels, white blood cell count, platelets count, blood glucose and glutamic oxaloacetic transaminase plasma levels were observed. Total cholestero...Continue Reading

References

Oct 1, 1996·Kidney International·T F AndohW M Bennett
May 2, 2002·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Gregory I SnellTrevor J Williams
May 14, 2003·Circulation·Donna ManciniAndrew R Marks
Oct 4, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Kyrsten D FairbanksPaul J Thuluvath
Nov 25, 2004·The Annals of Thoracic Surgery·Federico VenutaGiorgio F Coloni

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Citations

Aug 20, 2014·Drugs·Francisco González-Vílchez, José Antonio Vázquez de Prada
Feb 8, 2007·Current Opinion in Cardiology·Finn Gustafsson, Heather J Ross
Feb 8, 2007·Current Opinion in Cardiology·Marcelo Cantarovich
Oct 22, 2008·European Heart Journal·Maria G Crespo-Leiro, Manuel Hermida-Prieto
Dec 9, 2008·Current Opinion in Organ Transplantation·Eugenia Raichlin, Sudhir S Kushwaha
Jun 23, 2009·Current Opinion in Organ Transplantation·Finn Gustafsson, Heather J Ross
Feb 9, 2012·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Dirk UhlmannHelmut Witzigmann
Oct 17, 2013·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Sebastian MichelIngo Kaczmarek
Jul 10, 2008·Expert Opinion on Drug Metabolism & Toxicology·Ana I Sánchez-Fructuoso
Jul 14, 2010·Transplantation Reviews·Nicolás ManitoJavier Segovia
Dec 8, 2009·Current Problems in Cardiology·Barry A BoilsonSudhir S Kushwaha
Sep 1, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Marcelo CantarovichJeffrey Barkun
Mar 31, 2009·Journal of Cardiac Failure·Reinaldo B Bestetti, Tatiana A D Theodoropoulos
Oct 9, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Finn GustafssonDiego H Delgado
Sep 25, 2007·Transplantation Proceedings·M UbillaG Rábago
Jan 30, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Oliver J WagnerBernhard Egger
Jul 11, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A ZuckermannS Kushwaha
Jul 11, 2012·Clinical Transplantation·Jennifer T ThibodeauMark H Drazner
Dec 7, 2013·Clinical Transplantation·Jennifer T ThibodeauMark H Drazner
Oct 14, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A ZuckermannM G Crespo-Leiro
Aug 16, 2008·Journal of the American College of Cardiology·Sharon A Hunt, François Haddad
Nov 24, 2012·São Paulo Medical Journal = Revista Paulista De Medicina·Alexandre LibórioJuan Mejia
Jul 4, 2018·Korean Circulation Journal·In Cheol KimJon A Kobashigawa
Mar 14, 2007·Transplantation·Richard Borrows, Paul Cockwell

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