Impact on renal function of the use of sirolimus in cardiac transplantation

Transplant Proc. 2007 Sep;39(7):2401-2. doi: 10.1016/j.transproceed.2007.07.060.

Abstract

Introduction: During the last few years sirolimus has been introduced as an alternative to preserve renal function in transplant recipients receiving calcineurin inhibitors.

Materials and methods: We reviewed our results on the use of sirolimus in cardiac transplant recipients.

Results: Twenty-seven patients with an average age of 63 years received sirolimus. The average time after transplantation was 73.4 +/- 58.9 months and the average follow-up was 31.7 +/- 18.01 months. Sirolimus was prescribed in 37% of cases due to chronic renal failure (CRF), 14.8% because of cardiac allograft vasculopathy (CAV), 11.1% for tumors, 22.2% de novo, 7.4% for CRF and tumor, and 7.4% for CRF and CAV. Among the patients with CRF (n = 14), there were 5 (35%) on dialysis at the moment of starting the treatment and 1 was retired from dialysis. The other 4 (28.5%) patients had to be treated with dialysis after starting the treatment. In all, 42.8% of the patients with nephropathy maintained stable renal function or improved. Among the 17 (63%) patients who did not require dialysis, there was no significant change in renal function after 6 months or 1, 2, and 3 years follow-up.

Conclusions: The use of sirolimus in cardiac transplantation maintains stable renal function in the majority of patients in the medium term.

MeSH terms

  • Aged
  • Creatinine / blood*
  • Female
  • Heart Transplantation / immunology
  • Heart Transplantation / physiology*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Function Tests*
  • Male
  • Middle Aged
  • Postoperative Complications / classification
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Sirolimus / therapeutic use*

Substances

  • Immunosuppressive Agents
  • Creatinine
  • Sirolimus