Sirolimus (rapamycin) reduces the incidence of acute rejection episodes in renal transplantation: an initial experience in Taiwan.
BACKGROUND
Acute rejection is the major cause of graft loss in renal transplantation. Sirolimus (rapamycin) inhibits the effects of cytokines on T and B cells; therefore, it provides prophylaxis against acute renal rejection. This open-label trial assessed the incidence of biopsy-confirmed acute rejection episodes, variation in renal function, as well as graft and patient survival rates up to 12 months posttransplantation when using sirolimus in combination with cyclosporine and prednisolone as immunosuppressants.


METHODS
Ten kidney transplant recipients received sirolimus 2 mg daily after a 6-mg loading dose. Doses were then adjusted to keep the whole-blood trough level between 5 and 20 mg/mL. All patients received sirolimus in combination with cyclosporine and prednisolone.


RESULTS
At 12 months after renal transplantation, the graft and patient survival rates were 90% and 90%, respectively. One patient died at 2 months due to sepsis with a functioning graft. The mean serum creatinine levels at 1, 3, and 6 months were 1.59 mg/dL, 1.71 mg/dL, and 1.65 ml/dL, respectively. There was no biopsy-confirmed acute rejection episode within 12 months.


CONCLUSIONS
Sirolimus in combination with cyclosporine and prednisolone significantly protected kidney transplant recipients from acute rejection for up to 1 year of follow-up.
Liu
K-L
KL
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Chu
S-H
SH
Chiang
Y-J
YJ
Wu
C-T
CT
Chen
Y
Y
D000208:Acute Disease; D000328:Adult; D002102:Cadaver; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D019520:Living Donors; D008875:Middle Aged; D020123:Sirolimus / Q000627:therapeutic use*; D013624:Taiwan; D014019:Tissue Donors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D020123:Sirolimus