Practical recommendations for the early use of m-TOR inhibitors (sirolimus) in renal transplantation.
m-TOR inhibitors (e.g. sirolimus) are well-tolerated immunosuppressants used in renal transplantation for prophylaxis of organ rejection, and are associated with long-term graft survival. Early use of sirolimus is often advocated by clinicians, but this may be associated with a number of side-effects including impaired wound-healing, lymphoceles and delayed graft function. As transplant clinicians with experience in the use of sirolimus, we believe such side-effects can be limited by tailored clinical management. We present recommendations based on published literature and our clinical experience. Furthermore, guidance is provided on sirolimus use during surgery, both at transplantation and for subsequent operations.
Campistol
Josep M
JM
Unidad de Transplante Renal, Hospital Clinic i Provincial, Barcelona 08036, Spain. jmcampis@clinic.ub.es
Cockwell
Paul
P
Diekmann
Fritz
F
Donati
Donato
D
Guirado
Luis
L
Herlenius
Gustaf
G
Mousa
Dujanah
D
Pratschke
Johann
J
San Millán
Juan Carlos Ruiz
JC
D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation; D016030:Kidney Transplantation / Q000379:methods*; D008210:Lymphocele / Q000378:metabolism; D011494:Protein Kinases / Q000378:metabolism*; D012307:Risk Factors; D020123:Sirolimus / Q000627:therapeutic use*; D013256:Steroids / Q000378:metabolism; D058570:TOR Serine-Threonine Kinases; D016896:Treatment Outcome; D014945:Wound Healing
D007166:Immunosuppressive Agents; D013256:Steroids; D011494:Protein Kinases; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D020123:Sirolimus