Rapamycin in Lung Transplantation

Survival Associated With Sirolimus Plus Tacrolimus Maintenance Without Induction Therapy Compared With Standard Immunosuppression After Lung Transplant

“…However, because sirolimus initiation is usually delayed for 3 to 12 months after transplant, most sirolimus-treated patients must be identified from a follow-up immunosuppression record in the data set (occasionally available at 3 or 6 months but usually available only at 1 year after transplant or at death for patients who died within the first year). Because sirolimus use in the first year is sometimes for rescue rather than prophylactic use, commonly after the onset of chronic rejection or malignant disease 7,13,17 (which are both reported annually in the UNOS data set), patients experiencing chronic rejection or malignant disease in the first year would be more likely to receive sirolimus. To avoid this potential source of confounding, primary analyses were based on patients free of chronic rejection and malignant disease (and alive) at 1 year after transplant in all treatment groups.…”

“…Potential benefits of sirolimus include multiple mechanisms for preventing chronic rejection 4,5,6,7 and anticancer 8,9,10,11 and antiaging 10,12 effects. Sirolimus has been an effective rescue therapy in lung transplantation after chronic rejection 7 or skin cancer 13 occurred with other immunosuppressants. The limited extent of prior studies 6,14,15,16 on prophylactic sirolimus use in lung transplantation has led to inconclusive findings, although results were favorable in most studies.…”

“…Potential benefits of sirolimus include multiple mechanisms for preventing chronic rejection and anticancer and antiaging effects. Sirolimus has been an effective rescue therapy in lung transplantation after chronic rejection or skin cancer occurred with other immunosuppressants.…”