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Updated: Jul 18, 2026

Surgical Angiogenesis in Porcine Tibial Allotransplantation: A New Large Animal Bone Vascularized Composite Allotransplantation Model
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Sirolimus experience in heart transplantation.

A Aranda-Dios1, E Lage, J M Sobrino

  • 1Department of Cardiology, University Hospital Virgen del Rocío, Seville, Spain. arandios@hotmail.com

Transplantation Proceedings
|November 14, 2006
PubMed
Summary

Sirolimus improved kidney function in heart transplant patients with calcineurin inhibitor-related renal dysfunction. A de novo sirolimus regimen preserved kidney function but showed increased rejection rates.

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Area of Science:

  • Nephrology
  • Immunology
  • Cardiology

Background:

  • Sirolimus is an immunosuppressant with antiproliferative properties.
  • It is nonnephrotoxic and shows potential for managing renal dysfunction post-transplant.
  • Limited data exist on de novo sirolimus regimens in high-risk patients.

Purpose of the Study:

  • To evaluate sirolimus-based immunosuppression in heart transplant recipients.
  • To assess sirolimus for converting from calcineurin inhibitors (CNIs) in patients with renal dysfunction.
  • To evaluate de novo sirolimus regimens in select heart transplant patients.

Main Methods:

  • Retrospective analysis of 25 heart transplant recipients.
  • 17 patients converted from CNIs to sirolimus for renal dysfunction.

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  • 6 patients received a de novo sirolimus regimen; 2 received it due to posttransplant neoplasms.

    • Main Results:

    • Serum creatinine levels significantly decreased post-conversion from CNIs to sirolimus.
    • Kidney function improved and was maintained up to 1 year post-conversion.
    • The de novo sirolimus group showed a higher incidence of moderate rejection; side effects were common.

    Conclusions:

    • Sirolimus effectively improved late CNI-related chronic renal dysfunction in heart transplant recipients.
    • A de novo CNI-free regimen with sirolimus preserved kidney function in recent heart transplant recipients.
    • Sirolimus use requires careful monitoring due to potential side effects and rejection rates.