Usefulness of sirolimus as rescue therapy in heart transplant recipients with renal failure: analysis of the Spanish Multicenter Observational Study (RAPACOR)

Transplantation Proceedings
Juan Francisco DelgadoEulalia Roig

Abstract

Chronic renal failure is a common complication of heart transplantation. Sirolimus (SRL) is an immunosuppressive drug that, unlike calcineurin inhibitors (CNIs), is not associated with nephrotoxicity. We collected efficacy and safety data from a Spanish registry of heart transplant recipients who were switched from a CNI to SRL due to renal failure. Patients were included if the serum creatinine level before switching was >1.5 mg/dL and/or the estimated creatinine clearance level was below 50 mL/min. Ninety-seven patients started SRL due to renal impairment. When SRL was started, CNIs were progressively tapered and in some cases withdrawn. Mean baseline creatinine level was 2.5 mg/dL and mean creatinine clearance level was 39 mL/min. Only 1 episode of acute rejection was observed in a patient receiving SRL plus cyclosporine (CsA) but the eventual allograft function remained stable. Compared with baseline, a significant improvement in renal function was observed at 6 months among patients who stopped CNIs before the third month after SRL was started, although not among those who continued taking CNIs. Upon multivariate analysis, no predictors of response were observed. SRL was withdrawn in 18% of patients due to adverse events. ...Continue Reading

References

Jul 26, 2000·Transplantation·D R DaviesJ Pardo
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
Sep 16, 2004·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jan GroetznerBruno Reichart
Sep 16, 2004·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Nicolas ManitoEnrique Esplugas
Nov 22, 2005·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Judson HuntMichael J Mack
Dec 21, 2005·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sudhir S KushwahaBrooks S Edwards
Sep 12, 2006·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Juan F DelgadoCarlos S de la Calzada
Aug 19, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·David O TaylorMarshall I Hertz
Oct 18, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Francisco González-VílchezRafael Martín-Durán

❮ Previous
Next ❯

Citations

Aug 20, 2014·Drugs·Francisco González-Vílchez, José Antonio Vázquez de Prada
Sep 13, 2013·Clinical Transplantation·Francisco González-VílchezMarta Farrero
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
Sep 24, 2016·Pediatric Transplantation·Caroline M SierraRichard E Chinnock
Nov 19, 2011·Immunotherapy·Massimiliano VerouxPierfrancesco Veroux

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

© 2022 Meta ULC. All rights reserved