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Sirolimus as renal and immunological rescue agent in pediatric liver transplant recipients
Author(s) -
Basso MariaSole,
Subramaniam Pushpa,
Tredger Mike,
Verma Anita,
Heaton Nigel,
Rela Mohamed,
MieliVergani Giorgina,
Dhawan Anil
Publication year - 2011
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2011.01560.x
Subject(s) - medicine , chronic allograft nephropathy , gastroenterology , nephropathy , nephrotoxicity , renal function , discontinuation , urology , creatinine , sirolimus , calcineurin , immunosuppression , kidney disease , transplantation , surgery , kidney transplantation , kidney , endocrinology , diabetes mellitus
Basso M‐S, Subramaniam P, Tredger M, Verma A, Heaton N, Rela M, Mieli‐Vergani G, Dhawan A. Sirolimus as renal and immunological rescue agent in pediatric liver transplant recipients.
Pediatr Transplantation 2011: 15: 722–727. © 2011 John Wiley & Sons A/S. Abstract: CNI have improved the outcome of LT. However, their inherent potential to nephrotoxic and sometimes‐inadequate immunosuppressive effect has lead to the usage of newer drugs like SRL. Aim of this study was to review children who received SRL. Thirty‐seven (20 women) children post‐LT, median age 10.4 yr (0.8–17.4) with a minimum follow‐up of six months comprised the study group. Indications for SRL were biopsy‐proven resistant acute allograft rejection (n = 12), early CR (n = 12), and CNI‐induced nephropathy with MMF intolerance (n = 11). In two patients, the indication was the recurrence of BSEP disease in the allograft. In patients with acute rejection, AST normalized in 10/12 patients. In patients with CR, AST normalized in 6/12 patients. Those with renal impairment showed improvement in their creatinine levels from a mean baseline of 99–56.7 μ m (p = 0.03) and their mean cystatin C was 1.02 after SRL. Side effects leading to discontinuation of SRL were seen in three patients. SRL was effective in rescuing patients with acute and chronic allograft rejection and improving renal function in CNI‐induced nephropathy group.