Linear growth in pediatric renal transplant recipients receiving sirolimus

• Published in: Pediatric transplantation Vol. 15; no. 6; pp. 570 - 572
• Main Authors: Hymes, Leonard C., Warshaw, Barry L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2011; Blackwell
• Subjects: Adolescent; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Body Size; Bone and Bones - pathology; Child; Child, Preschool; children; Female; General aspects; Glomerular Filtration Rate; growth; Humans; Immunosuppressive Agents - pharmacology; Infant; Kidney Transplantation - methods; Male; Medical sciences; Muscles - pathology; Pharmacology. Drug treatments; renal transplantation; Retrospective Studies; sirolimus; Sirolimus - pharmacology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Human; Antineoplastic agent; Pediatrics; Sirolimus; Growth; renal transplantation; Lactone; Homotransplantation; Macrolide; Kidney; Macrocycle; Antibiotic; Treatment; Urinary system; children; Surgery; Graft; Protein synthesis inhibitor; Immunosuppressive agent; Antibacterial agent; Child; Kidney transplantation
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/j.1399-3046.2011.01574.x

Hymes LC, Warshaw BL. Linear growth in pediatric renal transplant recipients receiving sirolimus.
Pediatr Transplantation 2011: 15: 570–572. © 2011 John Wiley & Sons A/S. :  SRL is a potent macrolide immunosuppressive agent that can be used as maintenance therapy for prevention of rejection and avoidance of CNI nephrotoxicity. However, animal studies indicate that SRL may inhibit skeletal and muscle growth. We analyzed linear growth in 25 children, age 1–15 yr old, maintained on SRL to determine whether SRL is detrimental to linear growth. Height z‐scores at baseline were compared with those at 24 months. We also compared linear growth in children receiving SRL to patients maintained on TAC. Height z‐scores over 24 months did not significantly change in the SRL group as a whole. Z‐scores improved in 13 of 25 patients (52%). Children with improved z‐scores were significantly younger than patents who did not display improved growth: 6 ± 5 yr vs. 11 ± 4 yr (p < 0.05). Height z‐scores in SRL and TAC‐based patients were no different initially and at 24 months, and a similar number of patients in each group displayed improved height scores. Height z‐scores improved in 52% of patients on SRL and occurred predominantly in younger patients for the initial 24 months of treatment. Linear growth in SRL patients was also similar to the results in TAC‐based patients. Therefore, our data did not identify a significant adverse effect of SRL on growth.