Sirolimus in pediatric renal transplantation.
Identifieur interne : 007E79 ( Main/Exploration ); précédent : 007E78; suivant : 007E80Sirolimus in pediatric renal transplantation.
Auteurs : J P Ibá Ez [Argentine] ; M L Monteverde ; J. Goldberg ; M A Diaz ; A. TurconiSource :
- Transplantation proceedings [ 0041-1345 ] ; 2005.
Descripteurs français
- KwdFr :
- MESH :
- immunologie : Transplantation rénale.
- usage thérapeutique : Immunosuppresseurs, Sirolimus.
- Enfant, Facteurs temps, Humains, Taux de filtration glomérulaire, Études de suivi, Études rétrospectives.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Immunosuppressive Agents, Sirolimus.
- drug effects : Glomerular Filtration Rate.
- immunology : Kidney Transplantation.
- Child, Follow-Up Studies, Humans, Retrospective Studies, Time Factors.
Abstract
Side effects of calcineurin inhibitors (CNIs) include nephrotoxicity and hypertension. Moreover, children have a higher risk of infections and posttransplantation lymphoproliferative disorders. We retrospectively evaluated the efficacy and safety of Sirolimus (SRL) in 18 patients, who were 10.52 +/- 5.03 years at time of transplantation and received a CNI as the core immunosuppression. The most common indications for starting SRL therapy were chronic allograft nephropathy, Epstein-Barr virus-associated neoplasia, and thrombotic microangiopathy. The patients were converted to SRL at 49.14 +/- 45.9 months posttransplantation. Mean follow-up after the switch to SRL was 13.83 +/- 7.24 months. All patients who began SRL therapy remained on that medication. We observed a significant improvement (P < .05) in glomerular filtration rate assessed using the Schwartz formula at 3 months, which was sustained thereafter. There were no changes in proteinuria, plasma lipids, and platelet number. Although the prevalence of hypertensive patients decreased during follow-up, it was not significant. There was one steroid-sensitive, acute rejection episode. Serious adverse events included 1 death due to a relapse of B lymphoma, 1 sepsis, and 1 pancreatic pseudo-cyst. Adverse events were present in 17% of patients: 3 Herpes Simplex infections, and 1 dose-related lymphedema. Further studies are necessary to assess the impact of adverse events in the pediatric transplant population receiving SRL as immunosuppression.
DOI: 10.1016/j.transproceed.2004.12.242
PubMed: 15848500
Affiliations:
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Garrahan, Buenos Aires, Argentina. juanibanez@sinectis.com.ar</nlm:affiliation><country xml:lang="fr">Argentine</country><wicri:regionArea>Division of Nephrology and Pathology, Hospital de Pediatria Dr. Juan P. Garrahan, Buenos Aires</wicri:regionArea><wicri:noRegion>Buenos Aires</wicri:noRegion></affiliation></author><author><name sortKey="Monteverde, M L" sort="Monteverde, M L" uniqKey="Monteverde M" first="M L" last="Monteverde">M L Monteverde</name></author><author><name sortKey="Goldberg, J" sort="Goldberg, J" uniqKey="Goldberg J" first="J" last="Goldberg">J. Goldberg</name></author><author><name sortKey="Diaz, M A" sort="Diaz, M A" uniqKey="Diaz M" first="M A" last="Diaz">M A Diaz</name></author><author><name sortKey="Turconi, A" sort="Turconi, A" uniqKey="Turconi A" first="A" last="Turconi">A. Turconi</name></author></analytic><series><title level="j">Transplantation proceedings</title><idno type="ISSN">0041-1345</idno><imprint><date when="2005" type="published">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Child</term><term>Follow-Up Studies</term><term>Glomerular Filtration Rate (drug effects)</term><term>Humans</term><term>Immunosuppressive Agents (therapeutic use)</term><term>Kidney Transplantation (immunology)</term><term>Retrospective Studies</term><term>Sirolimus (therapeutic use)</term><term>Time Factors</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Enfant</term><term>Facteurs temps</term><term>Humains</term><term>Immunosuppresseurs (usage thérapeutique)</term><term>Sirolimus (usage thérapeutique)</term><term>Taux de filtration glomérulaire ()</term><term>Transplantation rénale (immunologie)</term><term>Études de suivi</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Immunosuppressive Agents</term><term>Sirolimus</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Glomerular Filtration Rate</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Transplantation rénale</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Kidney Transplantation</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Immunosuppresseurs</term><term>Sirolimus</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child</term><term>Follow-Up Studies</term><term>Humans</term><term>Retrospective Studies</term><term>Time Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Enfant</term><term>Facteurs temps</term><term>Humains</term><term>Taux de filtration glomérulaire</term><term>Études de suivi</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Side effects of calcineurin inhibitors (CNIs) include nephrotoxicity and hypertension. Moreover, children have a higher risk of infections and posttransplantation lymphoproliferative disorders. We retrospectively evaluated the efficacy and safety of Sirolimus (SRL) in 18 patients, who were 10.52 +/- 5.03 years at time of transplantation and received a CNI as the core immunosuppression. The most common indications for starting SRL therapy were chronic allograft nephropathy, Epstein-Barr virus-associated neoplasia, and thrombotic microangiopathy. The patients were converted to SRL at 49.14 +/- 45.9 months posttransplantation. Mean follow-up after the switch to SRL was 13.83 +/- 7.24 months. All patients who began SRL therapy remained on that medication. We observed a significant improvement (P < .05) in glomerular filtration rate assessed using the Schwartz formula at 3 months, which was sustained thereafter. There were no changes in proteinuria, plasma lipids, and platelet number. Although the prevalence of hypertensive patients decreased during follow-up, it was not significant. There was one steroid-sensitive, acute rejection episode. Serious adverse events included 1 death due to a relapse of B lymphoma, 1 sepsis, and 1 pancreatic pseudo-cyst. Adverse events were present in 17% of patients: 3 Herpes Simplex infections, and 1 dose-related lymphedema. Further studies are necessary to assess the impact of adverse events in the pediatric transplant population receiving SRL as immunosuppression.</div></front></TEI><affiliations><list><country><li>Argentine</li></country></list><tree><noCountry><name sortKey="Diaz, M A" sort="Diaz, M A" uniqKey="Diaz M" first="M A" last="Diaz">M A Diaz</name><name sortKey="Goldberg, J" sort="Goldberg, J" uniqKey="Goldberg J" first="J" last="Goldberg">J. Goldberg</name><name sortKey="Monteverde, M L" sort="Monteverde, M L" uniqKey="Monteverde M" first="M L" last="Monteverde">M L Monteverde</name><name sortKey="Turconi, A" sort="Turconi, A" uniqKey="Turconi A" first="A" last="Turconi">A. Turconi</name></noCountry><country name="Argentine"><noRegion><name sortKey="Iba Ez, J P" sort="Iba Ez, J P" uniqKey="Iba Ez J" first="J P" last="Ibá Ez">J P Ibá Ez</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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