Sirolimus conversion in liver transplant recipients with calcineurin inhibitor-induced complications: Efficacy and safety

Wei Qiang Ju, Zhi Yong Guo, Wen Hua Liang, Lin Wei Wu, Qiang Tai, An Bin Hu, Ming Han, Xiao Feng Zhu, Xiaoshun He

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objectives: To evaluate the efficacy and safety of conversion from calcineurin inhibitors to sirolimus among liver transplant recipients with calcineurin inhibitor-induced complications. Materials and Methods: After receiving liver transplants, 25 patients with calcineurin inhibitorinduced complications (22 renal dysfunction and 3 new-onset diabetes mellitus) were converted from sirolimus to tacrolimus. The serum creatinine, sirolimus trough level, liver function, acute rejection episodes, and drug-related adverse effects were monitored. Results: The patients were followed for 12 to 50 months (median, 25 months). The renal function of the 22 patients with renal dysfunction improved after sirolimus conversion. The serum creatinine levels were significantly lower at 3 months after conversion versus before conversion (113.2 ± 21.8 μmol/L vs 163.2 ± 45.3 μmol/L; P <.05). At the end of the follow-up, the average serum creatinine level was 101.9 ± 23.4 μmol/L among the 20 living recipients. Diabetes also was under control in 3 diabetic recipients after the conversion. Four patients experienced episodes of acute rejection, and intravenous steroid bolus therapy was administered in 2 of them. No graft was lost because of acute rejection. The adverse effects of sirolimus included hyperlipidemia (7/25), anemia (8/25), and mouth ulcers (9/25). All these adverse effects were relieved after a short-term symptomatic therapy, and no patient was withdrawn from the conversion trial. Conclusions: Sirolimus monotherapy is effective and safe in liver transplant recipients. Conversion to sirolimus was associated with a sustained improvement in renal function and diabetes mellitus without an increased incidence of acute rejection episodes.

Original languageEnglish (US)
Pages (from-to)132-135
Number of pages4
JournalExperimental and Clinical Transplantation
Volume10
Issue number2
DOIs
StatePublished - Apr 1 2012

Keywords

  • Calcineurin inhibitors
  • Complications
  • Conversion
  • Liver transplant
  • Sirolimus

ASJC Scopus subject areas

  • Transplantation

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