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Practical recommendations for the early use of m-TOR inhibitors (sirolimus) in renal transplantation |
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| Authors: | Josep M. Campistol,Paul Cockwell,Fritz Diekmann,Donato Donati,Luis Guirado,Gustaf Herlenius,Dujanah Mousa,Johann Pratschke, Juan Carlos Ruiz San Millá n |
| Affiliation: | Unidad de Transplante Renal, Hospital Clinic i Provincial, Barcelona, Spain; Department of Nephrology, University Hospital Birmingham and Division of Medical Sciences, The University of Birmingham, Birmingham, UK; Department of Nephrology, CharitéCampus Mitte, Berlin, Germany; Hospital 'Ospedale di Circolo e Fondazione Macchi', Azienda Ospedaliera, Varese, Italy; Renal Transplant Unit, FundacióPuigvert, Barcelona, Spain; Department of Transplantation and Liver Surgery, Sahlgrenska University Hospital, Göteborg, Sweden; Renal Transplant Programme, Riyadh Military Hospital, Riyadh, Saudi Arabia; Department of General, Visceral and Transplantation Surgery, Charite-Universitätsmedizin, Berlin, Germany; Servicio de Nefrología, Hospital Universitario Valdecilla, Santander, Spain |
| Abstract: | m-TOR inhibitors (e.g. sirolimus) are well-tolerated immunosuppressants used in renal transplantation for prophylaxis of organ rejection, and are associated with long-term graft survival. Early use of sirolimus is often advocated by clinicians, but this may be associated with a number of side-effects including impaired wound-healing, lymphoceles and delayed graft function. As transplant clinicians with experience in the use of sirolimus, we believe such side-effects can be limited by tailored clinical management. We present recommendations based on published literature and our clinical experience. Furthermore, guidance is provided on sirolimus use during surgery, both at transplantation and for subsequent operations. |
| Keywords: | m-TOR inhibitors optimizing early use renal transplantation sirolimus |