Experience with sirolimus for calcineurin minimization/elimination in pancreas-after-kidney transplantation.
Pancreas after kidney (PAK) transplantation, associated with a persistent elevation in serum creatinine (defined as a >25% increase from baseline), was seen in 7 of 11 (64%) cases maintained on immunosuppressive therapy consisting of tacrolimus, mycophenolate mofetil, and prednisone. Patients were converted to sirolimus as a means of minimizing or eliminating exposure to tacrolimus, the presumed nephrotoxic agent. With the use of sirolimus-based immunosuppression, and with elimination or minimization of tacrolimus, renal function, as measured by serum creatinine, stabilized or improved in all cases.
Gautam
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Department of Surgery (Transplantation Surgery)-APC 921, Brown Medical School, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA. agautam@lifespan.org
Morrissey
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PE
Gohh
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Yango
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Monaco
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AP
D003404:Creatinine / Q000097:blood; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000276:immunology*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D016035:Pancreas Transplantation / Q000276:immunology*; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D020123:Sirolimus / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D003404:Creatinine; D009173:Mycophenolic Acid; D011241:Prednisone; D020123:Sirolimus