Abstract | BACKGROUND: METHODS: The study included orthotopic cardiac transplant (OHT) patients who required discontinuation of CNI due to worsening renal function ( creatinine clearance < 50 mL/min). We excluded subjects who had another indication for initiation of sirolimus, that is, rejection, malignancy, or allograft vasculopathy. The patients were followed for 6 months. The creatinine clearance (CrCl) was estimated according to the Cockcroft-Gault equation using the baseline weight and the serum creatinine at the time of introduction of sirolimus and 6 months there after. Nine patients were included, 7 (78%) were males and the overall mean age was 60.1 +/- 12.3 years and time since transplantation 8.7 +/- 6.1 years. The allograft was beyond 1 year in all patients. There was a significant improvement in the serum creatinine (2.98 +/- 0.9 to 1.69 +/- 0.5 mg/dL, P = .01) and CrCl (24.9 +/- 6.5 to 45.7 +/- 17.2 mL/min, P = .005) at 6 months follow-up. CONCLUSION: The replacement of CNI by sirolimus for imunosuppressive therapy for patients with renal failure after OHT was associated with a significant improvement in renal function after 6 months.
|
Authors | S M Ayub-Ferreira, M S Avila, F S Feitosa, G E C Souza, S Mangini, F G Marcondes-Braga, V S Issa, F Bacal, P R Chizzola, F D D Cruz, E A Bocchi |
Journal | Transplantation proceedings
(Transplant Proc)
Vol. 42
Issue 2
Pg. 542-4
(Mar 2010)
ISSN: 1873-2623 [Electronic] United States |
PMID | 20304188
(Publication Type: Journal Article)
|
Copyright | Copyright (c) 2010 Elsevier Inc. All rights reserved. |
Chemical References |
- Calcineurin Inhibitors
- Immunosuppressive Agents
- Creatinine
- Sirolimus
|
Topics |
- Aged
- Calcineurin Inhibitors
- Creatinine
(metabolism)
- Female
- Follow-Up Studies
- Heart Transplantation
(adverse effects, immunology, physiology)
- Humans
- Immunosuppressive Agents
(adverse effects, therapeutic use)
- Kidney Function Tests
- Male
- Middle Aged
- Patient Selection
- Renal Insufficiency
(epidemiology, etiology, prevention & control)
- Reoperation
(statistics & numerical data)
- Retrospective Studies
- Sirolimus
(adverse effects, therapeutic use)
- Time Factors
|