Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

23 August 2018 : Original article  

Early Sirolimus-Based Immunosuppression is Safe for Lung Transplantation Patients: Retrospective, Single Arm, Exploratory Study

Jacek Wojarski1ABCDF*, Sławomir Żegleń1ABCEF, Marek Ochman12ABCDEF, Wojtek Karolak1ABCDF

DOI: 10.12659/AOT.908471

Ann Transplant 2018; 23:598-607

Abstract

BACKGROUND: Sirolimus, a mechanistic target of sirolimus inhibitor, is an immunosuppression medication for patients undergoing heart and abdominal transplantation. Sirolimus-based immunosuppression administered de novo post-lung transplantation is associated with bronchial anastomosis healing-related complications. We hypothesized that sirolimus administration within the first postoperative month in selected lung transplant recipients is safe and may be associated with favorable short-term and long-term outcomes due to its anti-proliferative properties and minimal adverse side effects.

MATERIAL AND METHODS: Thirteen patients (13.3%; mean age, 46.8±11.9 years) received early sirolimus-based immunosuppression along with cyclosporine and prednisone; 10 patients received single-lung transplantation, 3 received double-lung transplantation, and all received induction immunosuppressants. Patients received early sirolimus-based immunosuppression after an uncomplicated postoperative course and detailed bronchoscopic assessment.

RESULTS: Sirolimus was begun on a mean of 20.6±4.7 days postoperatively (range, 14–32 days). The in-hospital and 30-day mortality rate was 0%. At long-term follow-up, 5 patients died (due to bacterial infection in 4 patients and pneumocystis jiroveci pneumonia in 1 patient). The mean overall survival was 4.4±2.53 (range, 0.8–10.0) years, 1-year survival was 92%, and 5-year survival was 62%. In 4 patients (30.8%), sirolimus was stopped due to infection in 3 patients and re-transplantation in 1 patient. Only one of the 13 patients developed bronchiolitis obliterans syndrome. In patients still taking sirolimus, renal function, systolic blood pressure, and lipid profile were within normal ranges; however, these patients required statin therapy.

CONCLUSIONS: In selected lung transplant recipients, early sirolimus-based immunosuppression is safe and associated with beneficial short-term and long-term outcomes.

Keywords: Immunosuppression, Lung Transplantation, Organ Transplantation, Sirolimus, TOR Serine-Threonine Kinases

0 Comments

SARS-CoV-2/COVID-19

29 November 2022 : Editorial  

Editorial: The World Health Organization (WHO) Fungal Priority Pathogens List in Response to Emerging Funga...

Med Sci Monit In Press; DOI: 10.12659/MSM.939088  

15 November 2022 : Original article  

Changes in Physical Activity Due to Fear of COVID-19 and Its Impact on Depression Among Post-Liver Transpla...

Ann Transplant In Press; DOI: 10.12659/AOT.938239  

12 April 2022 : Letter/Correspondence  

Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transpla...

Ann Transplant 2022; 27:e935863

In Press

28 Nov 2022 : Original article  

Hepatic Ischemia/Reperfusion Injury After Liver Transplantation Is Not Associated with Early Impairment of ...

Ann Transplant In Press; DOI: 10.12659/AOT.938105  

28 Nov 2022 : Original article  

Modification of Venous Outflow to Avoid Thrombotic Graft Failure in Pancreas Transplantation

Ann Transplant In Press; DOI: 10.12659/AOT.937514  

15 Nov 2022 : Original article  

Changes in Physical Activity Due to Fear of COVID-19 and Its Impact on Depression Among Post-Liver Transpla...

Ann Transplant In Press; DOI: 10.12659/AOT.938239  

14 Nov 2022 : Original article  

Pure Laparoscopic Versus Open Right Hepatectomy in Living Liver Donors: Graft Weight Discrepancy

Ann Transplant In Press; DOI: 10.12659/AOT.938274  

Most Viewed Current Articles

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

24 Jul 2020 : Review article  

Kidney Transplantation in the Times of COVID-19 – A Literature Review

DOI :10.12659/AOT.925755

Ann Transplant 2020; 25:e925755

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

24 Aug 2021 : Review article  

Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives

DOI :10.12659/AOT.931664

Ann Transplant 2021; 26:e931664

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358