Recovery of Renal Function in Heart Transplantation Patients After Conversion From a Calcineurin Inhibitor-Based Therapy to Sirolimus

Ayub‐Ferreira, Silvia Moreira; Avila, M.S.; Feitosa, Fernanda; Souza, Germano Emílio Conceição; Mangini, Sandrigo; Marcondes‐Braga, Fabiana G.; Issa, Victor Sarli; Bacal, Fernando; Chizzola, Paulo Roberto; Cruz, Fátima; Bocchi, Edimar Alcides

doi:10.1016/j.transproceed.2010.01.022

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…SIR therapy has also yielded increased triglyceride levels and proteinuria with limited change in blood pressure in most of the investigations. 8-12,29-34…”

Section: Discussionmentioning

confidence: 99%

“…The effects of SIR substitution for CNI on renal function have shown some encouraging yet controversial effects in cardiac transplant patients with suspected renal dysfunction caused by CNI toxicity. 7-14 The characterization of renal structural and functional abnormalities in patients with suspected CNI-induced nephrotoxicity, together with the evaluation of changes in renal function long term following SIR substitution have not been investigated in the same study. Accordingly, the primary objective of this clinical investigation was to assess the impact of SIR as a substitution for CNI on GFR at 6 months in stable long-term cardiac transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

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Sirolimus Immunoprophylaxis and Renal Histological Changes in Long-Term Cardiac Transplant Recipients

et al. 2014

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“…SIR therapy has also yielded increased triglyceride levels and proteinuria with limited change in blood pressure in most of the investigations. 8-12,29-34…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sirolimus Immunoprophylaxis and Renal Histological Changes in Long-Term Cardiac Transplant Recipients

et al. 2014

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Current awareness: Pharmacoepidemiology and drug safety

2010

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 23 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Antidiabetic Agents; 21 Contrast Agents; 22 Bone Conservation Agents; 23 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Chronic Renal Insufficiency in Heart Transplant Recipients: Risk Factors and Management Options

González‐Vílchez

Prada

2014

Drugs

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Renal dysfunction after heart transplantation is a frequently observed complication, in some cases resulting in significant limitation of quality of life and reduced survival. Since the pathophysiology of renal failure (RF) is multifactorial, the current etiologic paradigm for chronic kidney disease after heart transplantation relies on the concept of calcineurin inhibitor (CNI)-related nephrotoxicity acting on a predisposed recipient. Until recently, the management of RF has been restricted to the minimization of CNI dosage and general avoidance of classic nephrotoxic risk factors, with somewhat limited success. The recent introduction of proliferation signal inhibitors (PSIs) (sirolimus and everolimus), a new class of immunosuppressive drugs lacking intrinsic nephrotoxicity, has provided a completely new alternative in this clinical setting. As clinical experience with these new drugs increases, new renal-sparing strategies are becoming available. PSIs can be used in combination with reduced doses of CNIs and even in complete CNI-free protocols. Different strategies have been devised, including de novo use to avoid acute renal toxicity in high-risk patients immediately after transplantation, or more delayed introduction in those patients developing chronic RF after prolonged CNI exposure. In this review, the main information on the clinical relevance and pathophysiology of RF after heart transplantation, as well as the currently available experience with renal-sparing immunosuppressive regimens, particularly focused on the use of PSIs, is reviewed and summarized, including the key practical points for their appropriate clinical usage.

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Recovery of Renal Function in Heart Transplantation Patients After Conversion From a Calcineurin Inhibitor-Based Therapy to Sirolimus

Cited by 6 publications

References 5 publications

Sirolimus Immunoprophylaxis and Renal Histological Changes in Long-Term Cardiac Transplant Recipients

Sirolimus Immunoprophylaxis and Renal Histological Changes in Long-Term Cardiac Transplant Recipients

Current awareness: Pharmacoepidemiology and drug safety

Chronic Renal Insufficiency in Heart Transplant Recipients: Risk Factors and Management Options

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