Conversion to sirolimus in renal transplant patients with tumors
| Autor: | I. Perez Flores, Ana Sánchez-Fructuoso, Dolores Prats, N. Calvo, J. Conesa, N. Ridao, Alberto Barrientos, A. Rodríguez |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Urology Postoperative Complications Neoplasms medicine Humans Antibacterial agent Sirolimus Transplantation Kidney business.industry Immunosuppression medicine.disease Kidney Transplantation Surgery Calcineurin medicine.anatomical_structure Creatinine Sarcoma business Immunosuppressive Agents Kidney disease medicine.drug Follow-Up Studies |
| Zdroj: | Transplantation proceedings. 38(8) |
| ISSN: | 0041-1345 |
| Popis: | Background Conversion from calcineurin inhibitors (CNI) to sirolimus (SRL) is an option for renal transplant patients who develop a tumor. This strategy, however, may be associated with an increased risk of rejection. Aim We sought to evaluate a series of renal transplant patients who underwent conversion from CNI to SRL because they developed a tumor during the posttransplant period. Methods This prospective study of 29 patients included 2 patients with skin cancer (1 melanoma and 1 squamous cell carcinoma) and 27 patients who developed other tumors: lung ( n = 6), prostate ( n = 4), lymphoma ( n = 2), colon adenocarcinoma ( n = 2), kidney ( n = 2), Kaposi sarcoma ( n = 2), urothelium ( n = 1), parotid ( n = 1), larynx ( n = 1), gastric ( n = 1), breast ( n = 1), tongue ( n = 1), liver ( n = 1), xanthoastrocytoma ( n = 1), and aggressive angiomyxoma of the perineum ( n = 1). Results CNI were withdrawn in 28 patients and reduced in the remaining patient. Renal function was better when CNI were rapidly or abruptly suspended, with maintenance of cyclosporine (CsA) + SRL for more than 3 months being especially detrimental. Proteinuria worsened in patients whose preconversion levels were >0.5 g/d, particularly those treated with CsA. There was no episode of rejection. Conclusions SRL is a promising option for the management of posttransplant tumors. The switch in immunosuppression should be undertaken quickly, especially in patients under treatment with CsA. |
| Databáze: | OpenAIRE |
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