title: Renal function in renal or liver transplant recipients after conversion from a calcineurin inhibitor to sirolimus.
abstract: Two Six-month pilot studies were conducted in renal (n = 17) or liver (n = 15) transplant recipients to evaluate renal function after conversion from calcineurin inhibitor (CI)- to sirolimus (SRL)-based immunosuppression. After an SRL loading dose, doses were individualized to achieve whole blood trough levels of 10-22 ng/mL. Overall, serum creatinine did not change from baseline to six months post-conversion but an improvement from 219.9 to 201.4 micromol/L at three months was noted in renal transplant recipients (p < 0.05). Another finding was a numerical increase in the mean glomerular filtration rate (GFR) from 26.8 to 33.2 mL/min/1.73 m(2) at six months among liver transplant recipients (NS). All patients survived and all grafts were functioning at the end of the study. In conclusion, renal function remained stable, with a tendency towards improvement, after abrupt conversion from CI- to SRL-based therapy in renal or liver transplant recipients with moderate renal insufficiency.
authors.affiliation: Department of Transplantation and Liver Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. lars.backman@surgery.gu.se
authors.forename: L
authors.initials: L
authors.lastname: Bäckman
authors.forename: A Varberg
authors.initials: AV
authors.lastname: Reisaeter
authors.forename: L
authors.initials: L
authors.lastname: Wramner
authors.forename: B-G
authors.initials: BG
authors.lastname: Ericzon
authors.forename: K
authors.initials: K
authors.lastname: Salmela
authors.forename: C
authors.initials: C
authors.lastname: Brattström
mesh_terms: D065095:Calcineurin Inhibitors; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000502:physiology*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology*; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D051437:Renal Insufficiency; D020123:Sirolimus / Q000627:therapeutic use*; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine; D020123:Sirolimus; D016559:Tacrolimus