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Published on: November 8, 2015
Conversion to sirolimus in kidney transplant recipients: a single-center study
Mohammad Reza Ganji1, Monir Sadat Hakemi, Fatemeh Esfehani
1Department of Nephrology, Dr Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. mhakemi@tums.ac.ir
Iranian Journal of Kidney Diseases
|July 25, 2013
Summary
Converting from cyclosporine to sirolimus can maintain kidney transplant function. Early conversion is recommended to potentially improve outcomes and avoid nephrotoxicity associated with long-term cyclosporine use.
Area of Science:
- Nephrology
- Immunosuppression
- Transplantation
Background:
- Cyclosporine, a common immunosuppressant, poses a significant risk of nephrotoxicity in kidney transplant recipients.
- Assessing alternative immunosuppressive strategies is crucial for long-term graft survival and patient health.
Purpose of the Study:
- To evaluate the safety and efficacy of converting immunosuppression from cyclosporine to sirolimus in kidney transplant recipients.
- To determine the impact of sirolimus conversion on kidney allograft function and identify potential adverse effects.
Main Methods:
- A study involving 99 kidney transplant recipients who were converted from cyclosporine to sirolimus.
- Monitoring of serum creatinine, estimated glomerular filtration rate (eGFR), and adverse events at various time points post-conversion (1, 6, 12, 24, 36 months).
Main Results:
- Conversion was primarily due to chronic allograft nephropathy or cyclosporine nephrotoxicity.
- Early conversion (within 6 months post-transplant) showed a significant improvement in eGFR compared to late conversion.
- Sirolimus was discontinued in 16.6% of patients due to adverse effects; acute rejection rate was 4%.
Conclusions:
- Conversion from cyclosporine to sirolimus can lead to stable kidney allograft function.
- Early consideration for cyclosporine discontinuation and conversion to sirolimus is advised when indicated to preserve graft function.
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