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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Side effects of sirolimus

S Merkel1, N Mogilevskaja, M Mengel

  • 1Department of Nephrology, Medical School of Hannover, Hannover, Germany. Merkel.Saskia@mh-hannover.de

Transplantation Proceedings
|May 2, 2006
PubMed

Insights

Sirolimus offers improved renal transplant function but can cause adverse events like increased proteinuria and glomerulopathy. Caution is advised, especially for patients with existing glomerular conditions.

Area of Science:

  • Nephrology
  • Immunosuppression
  • Transplantation

Background:

  • The mTOR inhibitor sirolimus demonstrates improved renal transplant function over calcineurin inhibitors.
  • Sirolimus is often used as a conversion therapy for malignancies, deteriorating renal function, or hypertension post-transplant.

Purpose of the Study:

  • To retrospectively evaluate adverse events associated with sirolimus in renal transplant recipients.
  • To identify specific adverse events and their incidence in patients receiving sirolimus.

Main Methods:

  • Retrospective analysis of 119 renal transplant patients treated with sirolimus.
  • Evaluation of patient data including reasons for conversion, de novo initiation, and adverse event monitoring.

Main Results:

  • Common adverse events included elevated serum lipids and decreased hemoglobin.
  • Occasional adverse events comprised arthralgia, edema, gastrointestinal issues, skin disorders, electrolyte imbalances, and infections.
  • A significant 31% of patients experienced doubling or more of proteinuria, with 9/13 biopsies showing glomerulopathy (6 de novo, 3 recurrent).

Conclusions:

  • Sirolimus is associated with manageable adverse events but requires careful monitoring.
  • Increased proteinuria and glomerulopathy are notable risks, particularly in patients with pre-existing glomerular disease.

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