Conversion treatment with sirolimus in lung transplant recipients
10.3760/cma.j.issn.0254-1785.2015.08.010
- VernacularTitle:西罗莫司在肺移植受者中的转换治疗16例
- Author:
Dong WEI
;
Fei GAO
;
Bo WU
;
Min ZHOU
;
Jingyu CHEN
- Publication Type:Journal Article
- Keywords:
Sirolimus;
Lung transplantation;
Immunosuppressor;
Tumor;
Renal dysfunction
- From:
Chinese Journal of Organ Transplantation
2015;36(8):490-494
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy and safety of conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) as major immunosuppressive therapy in lung transplant recipients.Method Retrospective analyses were conducted for the clinical data of all the patients undergoing lung transplantation in Wuxi People's Hospital between January 2011 and December 2014.Sixteen were given conversion treatment with Sirolimus in the postoperative irnmunosuppressive therapy.We analyzed the opportunity and reasons in the conversion treatment,and the safety,effectiveness and complications of the conversion treatment.Result The follow-up period was 8 to 25 months,and the median time of conversion was 6 months after operation (2-18 months).The indications of conversion concluded:malignant tumor (n =8),renal dysfunction (n =5),lymphangioleiomyomatosis (n =1) and intractable diarrhea caused by CNIs (n =2).Four cases suffered from interstitial pneumonitis associated with Sirolimus and one case suffered from spontaneous pneumothorax,and they all conversed back to CNIs.In those patients,cancer recurrence occurred in 4 cases (of them,there were 3 deaths),and 3 patients developed chronic rejection.Those recipients receiving the conversion treatment due to renal dysfunction showed recovery of renal function to some extent.Conclusion It's effective and safe to converse the immunosuppressive therapy based on Sirolimus.Sirolimus should be reduced or withdrawn when interstitial pneumonitis associated with Sirolimus occurred.
