Sirolimus as an Alternative to Anticalcineurin Therapy in Heart Transplantation: Experience of a Single Center

Fernández-Valls, Mónica; González‐Vílchez, Francisco; Prada, José Antonio Vázquez de; Ruano, Javier; Ruisánchez, Cristina; Martín‐Durán, Rafael

doi:10.1016/j.transproceed.2005.09.152

Cited by 24 publications

(14 citation statements)

References 9 publications

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“…Other adverse outcomes (12,14). Our incidence of acute rejection in the CNI group was similar to the 33.3% reported by Kobashigawa (15), suggesting that our results are comparable to those of other centers.…”

Section: Bacterial Infections Early and Late Bacterial Infections Wersupporting

confidence: 90%

Outcomes Following De Novo CNI-Free Immunosuppression After Heart Transplantation: A Single-Center Experience

Leet¹,

Bergin²,

Richardson³

et al. 2009

American Journal of Transplantation

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Renal impairment at the time of heart transplantation complicates the choice of subsequent immunosuppressive therapy. Calcineurin (CNI)-free regimens utilizing proliferation signal inhibitors (PSI) may mitigate against nephrotoxicity in this group; however, their effectiveness remains unclear.We present our 7-year experience with de novo CNIfree, PSI-based immunosuppression after heart transplantation. Of the 152 patients transplanted between July 1999 and July 2006, de novo immunosuppression regimens were 49 CNI-free, PSI-based, 88 CNI, 15 combination of CNI+PSI.Pretransplant creatinine clearance improved within 6 months in the PSI group (0.69 ± 0.34 mL/s vs. 1.00 ± 0.54 mL/s, p < 0.05) but not the CNI (1.32 ± 0.54 mL/s vs. 1.36 ± 0.53 mL/s, p = ns) or CNI+PSI (1.20 ± 0.24 mL/s vs. 1.20 ± 0.41 mL/s, p = ns) groups. The PSI group had more episodes of early (≤6 months) acute rejection, bacterial or fungal infections and pleural effusions but less CMV infection (p < 0.05 for all comparisons). Early CNI addition occurred in 37% of the PSI group for acute rejection. 33% of the entire cohort changed immunosuppression regimens over 3.6 ± 2.2 years follow-up.De novo CNI-free, PSI-based immunosuppression in patients with significant renal dysfunction allowed significant posttransplantation renal recovery but with increased early acute rejection, bacterial and fungal infections and pleural effusions.

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Section: Bacterial Infections Early and Late Bacterial Infections Wersupporting

confidence: 90%

Outcomes Following De Novo CNI-Free Immunosuppression After Heart Transplantation: A Single-Center Experience

Leet¹,

Bergin²,

Richardson³

et al. 2009

American Journal of Transplantation

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“…A cut-off of 40 ml/min/1.73 m 2 in pre-conversion GFR was chosen on the basis of our previous experience, where we observed that this level could predict those patients with improvement in GFR after conversion to sirolimus. 18 All factors were included as fixed effects. A random patient intercept and identity scale covariance matrix were used.…”

Section: Discussionmentioning

confidence: 99%

Predictors of long-term renal function after conversion to proliferation signal inhibitors in long-term heart transplant recipients

González‐Vílchez

Prada

Castrillo

et al. 2011

The Journal of Heart and Lung Transplantation

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“…[13][14][15] This new approach provides a unique opportunity to spare renal function in the post-operative period, which is especially important in patients with pre-operative renal failure. The present observational study extends our preliminary reports 14,15 describing our experience in de novo heart transplantation in recipients with significant renal impairment using a CNI-free regimen consisting of a PSI (sirolimus or everolimus), an anti-mitotic drug, and corticosteroids from the time of transplantation.…”

mentioning

confidence: 99%

Avoidance of Calcineurin Inhibitors With Use of Proliferation Signal Inhibitors in De Novo Heart Transplantation With Renal Failure

González‐Vílchez

Prada

Expósito

et al. 2008

The Journal of Heart and Lung Transplantation

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Sirolimus as an Alternative to Anticalcineurin Therapy in Heart Transplantation: Experience of a Single Center

Cited by 24 publications

References 9 publications

Outcomes Following De Novo CNI-Free Immunosuppression After Heart Transplantation: A Single-Center Experience

Outcomes Following De Novo CNI-Free Immunosuppression After Heart Transplantation: A Single-Center Experience

Predictors of long-term renal function after conversion to proliferation signal inhibitors in long-term heart transplant recipients

Avoidance of Calcineurin Inhibitors With Use of Proliferation Signal Inhibitors in De Novo Heart Transplantation With Renal Failure

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