Sirolimus in de novo heart transplant recipients with severe renal impairment

• Published in: Transplant international Vol. 19; no. 3; pp. 245 - 248
• Main Authors: Vazquez de Prada, Jose A., Vilchez, Francisco G., Cobo, Manuel, Ruisanchez, Cristina, Valls, Mónica F., Ruano, Javier, Piñera, Celestino, Duran, Rafael M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.03.2006; Blackwell Publishing; Blackwell Publishing Ltd
• Subjects: Aged; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Calcineurin - metabolism; Calcineurin - pharmacology; Creatinine - metabolism; Dialysis; General aspects; heart transplantation; Heart Transplantation - methods; Hemofiltration; Humans; immunosuppression; Immunosuppressive Agents - pharmacology; Immunosuppressive Agents - therapeutic use; Kidney Diseases - complications; Kidney Diseases - metabolism; Kidney Transplantation - methods; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Pharmacology. Drug treatments; Renal failure; renal failure and sirolimus; Sirolimus - metabolism; Sirolimus - pharmacology; Sirolimus - therapeutic use; Time Factors; Heart; Nephrology; Sirolimus; Transplantation; Homotransplantation; Urology; Macrocycle; renal failure and sirolimus; Surgery; Graft; Kidney disease; Urinary system disease; heart transplantation; Lactone; Pharmacology; Macrolide; De novo; Medicine; Antibiotic; Immunosuppression; Nephropathy; Treatment; Renal failure; Circulatory system; Immunosuppressive agent; Antibacterial agent; Severe
• ISSN: 0934-0874; 1432-2277
• DOI: 10.1111/j.1432-2277.2005.00258.x

Summary Two patients with end‐stage heart failure and advanced renal dysfunction (under chronic dialysis therapy) underwent heart transplantation. In order to avoid further renal impairment, a calcineurine inhibitor‐free immunosuppression regimen based on the sirolimus was used. Although temporary perioperative support with hemofiltration and dyalisis was needed, both patients eventually regained a reasonable renal function with no episodes of clinical rejection and normal cardiac function at 13 and 11 months, respectively, after transplantation. Sirolimus‐based immunosuppression might be an interesting alternative to calcineurine inhibitors in the management of patients with significant renal impairment.