Review of symposium. Sirolimus in kidney transplantation.
Sirolimus (SRL) is a non-nephrotoxic immunosuppressive drug blocking T-cell proliferation through mTOR inhibition. SRL can be used as (1) an early drug in a calcineurin inhibitor-free protocol in the first 3 months after transplantation, (2) in the early and late conversion protocols as suggested by the multicenter randomized CONVERT trial, and (3) in recipients from marginal donors, because calcineurin inhibitors can increase the preexisting renal damage induced by age, hypertension, and diabetes that are frequent in elderly cadaveric donors. In any case, SRL should be used in patients with a cutoff of proteinuria (<or=800 mg/24 hr) or proteinuria-to-creatinine ratio less than 0.11.
Schena
Francesco P
FP
Renal, Dialysis and Transplant Unit, Department of Emergency and Organ Transplant, University of Bari, Bari, Italy. fp.schena@nephro.uniba.it
D002102:Cadaver; D002455:Cell Division / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology* / Q000502:physiology; D008213:Lymphocyte Activation / Q000187:drug effects; D015337:Multicenter Studies as Topic; D018579:Patient Selection; D011507:Proteinuria / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000627:therapeutic use*; D013601:T-Lymphocytes / Q000166:cytology / Q000187:drug effects / Q000276:immunology; D014019:Tissue Donors / Q000706:statistics & numerical data
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine; D020123:Sirolimus