[Clinical study of application of sirolimus with dose-reduced or discontinued cyclosporine A for prevention of acute rejection after kidney transplantation].
OBJECTIVE
To study the clinical efficacy, safety and feasibility of sirolimus (SRL) for preventing acute rejection of kidney transplantation.


METHODS
Thirty patients with end-stage kidney dysfunction received kidney transplants from June 2004 to December 2004. There were 21 male and 9 female aged from 22 to 67 years old, with a mean of (46.3 +/- 10.0) years old. SRL was used in primary immunosuppression therapy to prevent acute rejection after surgery, and all of them were treated in combination with dose-reduced cyclosporine A (CsA) and steroid. CsA reduction began 3 months after the surgery, the weekly dose of CsA about 10 to 25 percent reduction until completely discontinued. During a 4-year follow-up period, the adverse events, acute rejection and infection were observed and recorded in detail. The graft function and other laboratory indicators were checked and analyzed.


RESULTS
Of the 30 patients, 4 recipients died, patients survival rate was 86.7%. In other 26 cases, 25 recipients had good graft function, the average blood creatinine was (103.8 +/- 4.6) micromol/L at the end of 4(th) year and the incidence of acute rejection was 6.7% (2/30). The side effects included hyperlipidemia, proteinuria, delayed healing incision, lactate dehydrogenase increased and joint pain.


CONCLUSIONS
The combination of sirolimus with dose-reduced CsA till completely discontinued and steroid to prevent acute rejection of kidney transplantation is safe and efficient.
Lin
Jun
J
Urology Department, Beijing Friendship Hospital Affiliate of Capital University of Medical Sciences, Beijing 100050, China.
Tang
Ya-wang
YW
Sun
Wen
W
DU
Lin-dong
LD
Tian
Ye
Y
D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage* / Q000627:therapeutic use; D055815:Young Adult
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D020123:Sirolimus