title: Sirolimus and mycophenolate mofetil as calcineurin inhibitor-free immunosuppression in a cardiac transplant patient with chronic renal failure.
abstract: Chronic renal failure triggered by calcineurin inhibitor (CNI)-based immunosuppression is a common complication after cardiac transplantation. Sirolimus and mycophenolate mofetil (MMF) are 2 newer immunosuppressive agents with no documented nephrotoxic side effects. This case report describes a patient with ongoing chronic renal failure 10 months after cardiac transplantation on cyclosporine-based immunosuppressive therapy. Conversion of the immunosuppressive regimen from cyclosporine to sirolimus and MMF resulted in freedom from acute rejection, excellent cardiac graft function and consistently improved renal function. This case illustrates the beneficial potential of sirolimus and MMF as CNI-free and safe long-term immunosuppression in a patient with chronic renal failure after heart transplantation.
authors.affiliation: Department of Cardiac Surgery, Ludwig Maximilian University Hospital Grosshadem, Munich, Germany. jan.groetzner@hch.med.uni-muenchen.de
authors.forename: Jan
authors.initials: J
authors.lastname: Groetzner
authors.forename: Ingo
authors.initials: I
authors.lastname: Kaczmarek
authors.forename: Bruno
authors.initials: B
authors.lastname: Meiser
authors.forename: Markus
authors.initials: M
authors.lastname: Müller
authors.forename: Sabine
authors.initials: S
authors.lastname: Daebritz
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
mesh_terms: D019703:Calcineurin / Q000009:adverse effects; D065095:Calcineurin Inhibitors; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D020123:Sirolimus / Q000627:therapeutic use*
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D019703:Calcineurin; D009173:Mycophenolic Acid; D020123:Sirolimus