[Consensus-recommendations for sirolimus in liver transplantation]

Area of Science:

• Immunosuppression and Oncology in Transplantation
• Pharmacology of mTOR Inhibitors

Background:

• Sirolimus (m-TOR inhibitor) exhibits potential benefits in liver transplantation, including renal safety and anti-malignancy effects.
• Limited use of Sirolimus in liver transplantation is attributed to documented complications and drug safety warnings.
• A consensus meeting convened to evaluate the existing literature on Sirolimus's role in liver transplant recipients.

Framework:

• The consensus statement adheres to standard guideline presentation, incorporating evidence grading (1a-5).
• Recommendations are categorized by extent (A-C), reflecting the strength of evidence and expert opinion.
• The framework integrates published literature with the authors' clinical experience in managing Sirolimus post-transplant.

Implementation:

• Literature analysis focused on Sirolimus's efficacy and safety specifically within the liver transplantation setting.
• Evidence grading was applied to systematically assess the quality and relevance of available studies.
• Clinical experience of authors was incorporated to provide practical insights into Sirolimus use.

Implications:

• This consensus provides guidance on the potential role of Sirolimus in liver transplantation, balancing benefits and risks.
• The findings aim to inform clinical practice regarding the appropriate use of Sirolimus in this patient population.
• Further research may be warranted to clarify the optimal application of Sirolimus in liver transplant management.