title: Sirolimus in de novo heart transplant recipients with severe renal impairment.
abstract: Two patients with end-stage heart failure and advanced renal dysfunction (under chronic dialysis therapy) underwent heart transplantation. In order to avoid further renal impairment, a calcineurine inhibitor-free immunosuppression regimen based on the sirolimus was used. Although temporary perioperative support with hemofiltration and dialysis was needed, both patients eventually regained a reasonable renal function with no episodes of clinical rejection and normal cardiac function at 13 and 11 months, respectively, after transplantation. Sirolimus-based immunosuppression might be an interesting alternative to calcineurine inhibitors in the management of patients with significant renal impairment.
authors.affiliation: Department of Cardiology, Cardiac Transplantation Unit, Hospital Universitario Marques de Valdecilla, Avda Valdecilla s/n 39004 Santander, Cantabria, Spain. carvtj@humv.es
authors.forename: Jose A
authors.initials: JA
authors.lastname: Vazquez de Prada
authors.forename: Francisco G
authors.initials: FG
authors.lastname: Vilchez
authors.forename: Manuel
authors.initials: M
authors.lastname: Cobo
authors.forename: Cristina
authors.initials: C
authors.lastname: Ruisanchez
authors.forename: Mónica F
authors.initials: MF
authors.lastname: Valls
authors.forename: Javier
authors.initials: J
authors.lastname: Ruano
authors.forename: Celestino
authors.initials: C
authors.lastname: Piñera
authors.forename: Rafael M
authors.initials: RM
authors.lastname: Duran
mesh_terms: D000368:Aged; D019703:Calcineurin / Q000378:metabolism / Q000494:pharmacology; D003404:Creatinine / Q000378:metabolism; D003956:Dialysis; D016027:Heart Transplantation / Q000379:methods*; D006440:Hemofiltration; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000150:complications* / Q000378:metabolism; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine; D019703:Calcineurin; D020123:Sirolimus