We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Delayed introduction of sirolimus in paediatric intestinal transplant recipients: indications and long‐term benefits.
- Authors
Andres, Ane M.; Talayero, Paloma; Alcolea Sanchez, Alida; Sanchez Galán, Alba; Serradilla Rodríguez, Javier; Bueno Jimenez, Alba; Gonzalez Sacristan, Rocío; Stringa, Pablo; Papa Gobbi, Rodrigo; Lasa Lazaro, Maria; Díaz Almirón, Mariana; Ramos Boluda, Esther; Lopez Santamaría, Manuel; Hernández Oliveros, Francisco
- Abstract
Summary: To review our experience using sirolimus in a single centre paediatric intestinal transplantation cohort. Intestinal transplant patients with more than 3 months follow‐up were divided into two groups according to their immunosuppression regimen: tacrolimus, (TAC group, n = 45 grafts) or sirolimus (SRL group, n = 38 grafts), which included those partially or completely converted from tacrolimus to sirolimus. The indications to switch were tacrolimus side effects and immunological complications. Survival and complications were retrospectively analysed comparing both groups. SRL was introduced 9 months (0 months–16.9 years) after transplant. The main cause for conversion was worsening renal function (45%), followed by haemolytic anaemia (21%) and graft‐versus‐host‐disease (16%). Both groups showed a similar overall patient/graft survival (P = 0.76/0.08) and occurrence of rejection (24%/17%, P = 0.36). Immunological complications did not recur after conversion. Renal function significantly improved in most SRL patients. After a median follow‐up of 65.17 months, 28/46 survivors were on SRL, 26 with monotherapy, with good graft function. Over one‐third of our patients eventually required SRL conversion that allowed to improve their kidney function and immunological events, without entailing additional complications or survival impairment. Further trials are warranted to clarify the potential improvement of the standard tacrolimus maintenance by sirolimus conversion or addition.
- Subjects
RAPAMYCIN; INTESTINES; PEDIATRICS; GRAFT survival; HEMOLYTIC anemia
- Publication
Transplant International, 2021, Vol 34, Issue 10, p1895
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.13959