Journal article
Effects of prophylactic use of sirolimus on bronchiolitis obliterans syndrome development in lung transplant recipients
The Annals of thoracic surgery, Vol.97(1), pp.268-274
01/2014
DOI: 10.1016/j.athoracsur.2013.07.072
PMID: 24119986
Abstract
Sirolimus (SIR) has been shown to stabilize the lung function in lung transplant recipients with bronchiolitis obliterans syndrome (BOS). However, there is no long-term data on the prophylactic use of SIR in lung transplant recipients. This retrospective study examines the effects of SIR in the prevention of BOS.
From 1999 to 2009, 24 lung transplant recipients whose maintenance immunosuppression regimen consisted of tacrolimus (Tac), mycophenolate mofetil (MMF) or azathioprine (AZA), and prednisone (Pred), were switched to Tac, SIR, and Pred at 1 year after transplantation. From these 24 patients, 5 developed side effects that necessitated the cessation of SIR within 1 year, while 19 patients tolerated long-term use of SIR. The clinical outcomes of these 19 patients (SIR group) were compared with 22 lung transplant recipients whose immunosuppression regimen consisted of Tac, MMF or AZA, and Pred from the time of transplant (MMF group). Survival rates and freedom from BOS were calculated by the Kaplan-Meier method.
The SIR group had a lower incidence of BOS and viral infection (p = 0.05), and higher survival rates (p = 0.004). The SIR group had lower levels of Tac and received less Pred. The incidences of acute rejection, carcinoma, hypertension, and diabetes were similar between both groups.
Results from this study suggest that conversion to SIR 1 year after lung transplantation improves survival and decreases the development of BOS. Randomized studies with higher number of patients are needed to determine the prophylactic efficacy of sirolimus in preventing the development of BOS.
Details
- Title: Subtitle
- Effects of prophylactic use of sirolimus on bronchiolitis obliterans syndrome development in lung transplant recipients
- Creators
- Vikas Y Sacher - Department of Surgery, University of Miami, Miami, FloridaDebra Fertel - Division of Pulmonology, Jackson Health System, Miami, FloridaKaran Srivastava - Department of Surgery, University of Miami, Miami, FloridaAnthony Panos - Department of Surgery, University of Miami, Miami, FloridaDao Nguyen - Department of Surgery, University of Miami, Miami, FloridaTammy Baxter - Department of Surgery, University of Miami, Miami, FloridaShirin Shafazand - Department of Medicine, University of Miami, Miami, FloridaSi M Pham - Department of Surgery, University of Miami, Miami, Florida. Electronic address: spham@smail.umaryland.edu
- Resource Type
- Journal article
- Publication Details
- The Annals of thoracic surgery, Vol.97(1), pp.268-274
- Publisher
- Netherlands
- DOI
- 10.1016/j.athoracsur.2013.07.072
- PMID
- 24119986
- ISSN
- 0003-4975
- eISSN
- 1552-6259
- Language
- English
- Date published
- 01/2014
- Academic Unit
- Surgery; Cardiothoracic Surgery
- Record Identifier
- 9984051593102771
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