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The utilization of sirolimus and the impact on wound‐healing complications in obese kidney transplant recipients
Author(s) -
Hulbert Amanda L.,
Delahunty April J.,
Rajab Amer,
Forbes Rachel C.,
Winters Holli A.
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12183
Subject(s) - sirolimus , medicine , immunosuppression , body mass index , incidence (geometry) , urology , gastroenterology , surgery , optics , physics
Abstract Background Wound healing is a known complication associated with sirolimus therapy. Previous studies have demonstrated that obesity is a risk factor for wound‐healing complications ( WHC ) in patients receiving sirolimus therapy; however, the incidence has not been defined. Methods This is a single‐center, retrospective cohort study of de novo kidney transplant recipients ( KTR ) transplanted with a body mass index (BMI) of ≥30 kg/m 2 between January 2002 and April 2011 receiving sirolimus vs. sirolimus‐free maintenance immunosuppression. Results A total of 317 KTR , 71 sirolimus‐free patients and 246 sirolimus patients, were eligible for inclusion. There was no difference in the primary outcome of WHC within six months of transplant (sirolimus 32.1% vs. sirolimus‐free 29.6%, p = 0.107). Sirolimus exposure was not found to influence WHC ( OR 2.906, 95% CI 0.922–9.160); however, BMI Class II ( OR 1.830, 95% CI 1.051–3.186) and Class III ( OR 3.154, 95% CI 1.484–6.705) were significant predictors of WHC . There was no difference in WHC between the sirolimus group and sirolimus‐free group among patients in obesity Class I (27.3% vs. 15.1%, p = 0.064), Class II (36.6% vs. 34.8%, p = 0.195), or Class III (48.0% vs. 53.3%, p = 0.243). Conclusion In our experience, sirolimus does not increase WHC in obese KTR and can be safely used as maintenance immunosuppression immediately following transplant.