Nephrotoxicity caused by calcineurin inhibitors can lead to either delayed graft function or long-term decline of renal function after kidney transplantation. Therefore, recipients of renal transplants from marginal donors require non-nephrotoxic immunosuppression. Eighteen patients received kidney transplants from marginal donors, with a calcineurin inhibitor-free immunosuppressive regimen, based on basiliximab, mycophenolate mofetil, steroids, and sirolimus. Renal graft biopsy was performed in all cases before surgery. Mean follow-up was 11.8 months. We report immediate renal function in 9 patients, delayed graft function in 5 and acute tubular necrosis in 4 patients. One patient was successfully treated for biopsy-proven acute rejection. Hypercholesterolemia and hypertriglyceridemia were the most common adverse effects (n = 13) associated with arthralgia (n = 2) and thrombocytopenia (n = 2). Five patients underwent a switch to tacrolimus, due to sirolimus-induced side effects. Immunosuppression without the use of calcineurin inhibitors is a safe and effective regimen in kidney transplantation, although sirolimus-related side effects still represent a morbidity factor in these patients.

Pisani, F., Buonomo, O., Iaria, G., Iorio, B., Rizzello, A., Pollicita, S., et al. (2004). Sirolimus in kidney transplantation from marginal donors. TRANSPLANTATION PROCEEDINGS, 36(3), 495-496 [10.1016/j.transproceed.2004.02.011].

Sirolimus in kidney transplantation from marginal donors

Pisani, F.;Buonomo, O.;Iaria, G.;Iorio, B.;Boffo, V.;Casciani, C. U.
2004-01-01

Abstract

Nephrotoxicity caused by calcineurin inhibitors can lead to either delayed graft function or long-term decline of renal function after kidney transplantation. Therefore, recipients of renal transplants from marginal donors require non-nephrotoxic immunosuppression. Eighteen patients received kidney transplants from marginal donors, with a calcineurin inhibitor-free immunosuppressive regimen, based on basiliximab, mycophenolate mofetil, steroids, and sirolimus. Renal graft biopsy was performed in all cases before surgery. Mean follow-up was 11.8 months. We report immediate renal function in 9 patients, delayed graft function in 5 and acute tubular necrosis in 4 patients. One patient was successfully treated for biopsy-proven acute rejection. Hypercholesterolemia and hypertriglyceridemia were the most common adverse effects (n = 13) associated with arthralgia (n = 2) and thrombocytopenia (n = 2). Five patients underwent a switch to tacrolimus, due to sirolimus-induced side effects. Immunosuppression without the use of calcineurin inhibitors is a safe and effective regimen in kidney transplantation, although sirolimus-related side effects still represent a morbidity factor in these patients.
2004
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/18 - CHIRURGIA GENERALE
English
Con Impact Factor ISI
Pisani, F., Buonomo, O., Iaria, G., Iorio, B., Rizzello, A., Pollicita, S., et al. (2004). Sirolimus in kidney transplantation from marginal donors. TRANSPLANTATION PROCEEDINGS, 36(3), 495-496 [10.1016/j.transproceed.2004.02.011].
Pisani, F; Buonomo, O; Iaria, G; Iorio, B; Rizzello, A; Pollicita, S; De Luca, L; Valeri, M; Boffo, V; Famulari, A; Casciani, Cu
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/204131
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