Improved freedom from rejection after a loading dose of sirolimus

Rafik El-Sabrout, Veronica Delaney, Fauzia K. Butt, Mohamad Qadir, Pat Hanson, Sony Tuteja, David A. McCollum, Khalid Butt

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background. Sirolimus (SIR) in combination with cyclosporine reduces the incidence of acute rejection in renal transplant recipients. Limited data are available regarding SIR in combination with tacrolimus (TAC). Methods. A single-center, retrospective review of renal transplant recipients receiving SIR, TAC, and corticosteroids postoperatively was conducted. A total of 118 consecutive renal transplant recipients were included on the basis of availability of day 1 SIR dose information. Seventy-seven patients received an SIR loading dose (SIR-LD) immediately posttransplantation, and 41 patients did not (SIR no loading dose [SIR-NLD]). Results. The two groups showed similar demographic and transplant characteristics. SIR doses and trough levels were significantly higher in the SIR-LD patients at 1 and 7 days posttransplantation; however, no differences occurred beyond day 7. Patients receiving an SIR-LD experienced significantly better freedom from rejection at 1, 3, and 6 months posttransplantation (P<0.05). This rejection benefit in the SIR-LD group was independent of donor source and use of antibody induction. SIR-LD patients experienced fewer serious infections (12% SIR-LD vs. 27% SIR-NLD, P=0.04) and a lower incidence of delayed graft function (21% SIR-LD vs. 39% SIR-NLD, P<0.05). No significant differences in serum creatinine, hemoglobin, and platelet counts occurred in the first 180 days posttransplantation, but the patients in the SIR-NLD group experienced lower hemoglobin levels at day 30 than those in the SIR-LD group (10.8 g/dL SIR-LD vs. 9.7 g/dL SIR-NLD, P=0.03). Conclusion. SIR-LD significantly improves early posttransplantation freedom from rejection in renal transplant recipients without increasing other complications.

Original languageEnglish (US)
Pages (from-to)86-90
Number of pages5
JournalTransplantation
Volume75
Issue number1
DOIs
StatePublished - Jan 15 2003

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Sirolimus
Kidney
Tacrolimus
Hemoglobins
Delayed Graft Function
Incidence

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

El-Sabrout, R., Delaney, V., Butt, F. K., Qadir, M., Hanson, P., Tuteja, S., ... Butt, K. (2003). Improved freedom from rejection after a loading dose of sirolimus. Transplantation, 75(1), 86-90. https://doi.org/10.1097/00007890-200301150-00016
El-Sabrout, Rafik ; Delaney, Veronica ; Butt, Fauzia K. ; Qadir, Mohamad ; Hanson, Pat ; Tuteja, Sony ; McCollum, David A. ; Butt, Khalid. / Improved freedom from rejection after a loading dose of sirolimus. In: Transplantation. 2003 ; Vol. 75, No. 1. pp. 86-90.
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abstract = "Background. Sirolimus (SIR) in combination with cyclosporine reduces the incidence of acute rejection in renal transplant recipients. Limited data are available regarding SIR in combination with tacrolimus (TAC). Methods. A single-center, retrospective review of renal transplant recipients receiving SIR, TAC, and corticosteroids postoperatively was conducted. A total of 118 consecutive renal transplant recipients were included on the basis of availability of day 1 SIR dose information. Seventy-seven patients received an SIR loading dose (SIR-LD) immediately posttransplantation, and 41 patients did not (SIR no loading dose [SIR-NLD]). Results. The two groups showed similar demographic and transplant characteristics. SIR doses and trough levels were significantly higher in the SIR-LD patients at 1 and 7 days posttransplantation; however, no differences occurred beyond day 7. Patients receiving an SIR-LD experienced significantly better freedom from rejection at 1, 3, and 6 months posttransplantation (P<0.05). This rejection benefit in the SIR-LD group was independent of donor source and use of antibody induction. SIR-LD patients experienced fewer serious infections (12{\%} SIR-LD vs. 27{\%} SIR-NLD, P=0.04) and a lower incidence of delayed graft function (21{\%} SIR-LD vs. 39{\%} SIR-NLD, P<0.05). No significant differences in serum creatinine, hemoglobin, and platelet counts occurred in the first 180 days posttransplantation, but the patients in the SIR-NLD group experienced lower hemoglobin levels at day 30 than those in the SIR-LD group (10.8 g/dL SIR-LD vs. 9.7 g/dL SIR-NLD, P=0.03). Conclusion. SIR-LD significantly improves early posttransplantation freedom from rejection in renal transplant recipients without increasing other complications.",
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El-Sabrout, R, Delaney, V, Butt, FK, Qadir, M, Hanson, P, Tuteja, S, McCollum, DA & Butt, K 2003, 'Improved freedom from rejection after a loading dose of sirolimus', Transplantation, vol. 75, no. 1, pp. 86-90. https://doi.org/10.1097/00007890-200301150-00016

Improved freedom from rejection after a loading dose of sirolimus. / El-Sabrout, Rafik; Delaney, Veronica; Butt, Fauzia K.; Qadir, Mohamad; Hanson, Pat; Tuteja, Sony; McCollum, David A.; Butt, Khalid.

In: Transplantation, Vol. 75, No. 1, 15.01.2003, p. 86-90.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Improved freedom from rejection after a loading dose of sirolimus

AU - El-Sabrout, Rafik

AU - Delaney, Veronica

AU - Butt, Fauzia K.

AU - Qadir, Mohamad

AU - Hanson, Pat

AU - Tuteja, Sony

AU - McCollum, David A.

AU - Butt, Khalid

PY - 2003/1/15

Y1 - 2003/1/15

N2 - Background. Sirolimus (SIR) in combination with cyclosporine reduces the incidence of acute rejection in renal transplant recipients. Limited data are available regarding SIR in combination with tacrolimus (TAC). Methods. A single-center, retrospective review of renal transplant recipients receiving SIR, TAC, and corticosteroids postoperatively was conducted. A total of 118 consecutive renal transplant recipients were included on the basis of availability of day 1 SIR dose information. Seventy-seven patients received an SIR loading dose (SIR-LD) immediately posttransplantation, and 41 patients did not (SIR no loading dose [SIR-NLD]). Results. The two groups showed similar demographic and transplant characteristics. SIR doses and trough levels were significantly higher in the SIR-LD patients at 1 and 7 days posttransplantation; however, no differences occurred beyond day 7. Patients receiving an SIR-LD experienced significantly better freedom from rejection at 1, 3, and 6 months posttransplantation (P<0.05). This rejection benefit in the SIR-LD group was independent of donor source and use of antibody induction. SIR-LD patients experienced fewer serious infections (12% SIR-LD vs. 27% SIR-NLD, P=0.04) and a lower incidence of delayed graft function (21% SIR-LD vs. 39% SIR-NLD, P<0.05). No significant differences in serum creatinine, hemoglobin, and platelet counts occurred in the first 180 days posttransplantation, but the patients in the SIR-NLD group experienced lower hemoglobin levels at day 30 than those in the SIR-LD group (10.8 g/dL SIR-LD vs. 9.7 g/dL SIR-NLD, P=0.03). Conclusion. SIR-LD significantly improves early posttransplantation freedom from rejection in renal transplant recipients without increasing other complications.

AB - Background. Sirolimus (SIR) in combination with cyclosporine reduces the incidence of acute rejection in renal transplant recipients. Limited data are available regarding SIR in combination with tacrolimus (TAC). Methods. A single-center, retrospective review of renal transplant recipients receiving SIR, TAC, and corticosteroids postoperatively was conducted. A total of 118 consecutive renal transplant recipients were included on the basis of availability of day 1 SIR dose information. Seventy-seven patients received an SIR loading dose (SIR-LD) immediately posttransplantation, and 41 patients did not (SIR no loading dose [SIR-NLD]). Results. The two groups showed similar demographic and transplant characteristics. SIR doses and trough levels were significantly higher in the SIR-LD patients at 1 and 7 days posttransplantation; however, no differences occurred beyond day 7. Patients receiving an SIR-LD experienced significantly better freedom from rejection at 1, 3, and 6 months posttransplantation (P<0.05). This rejection benefit in the SIR-LD group was independent of donor source and use of antibody induction. SIR-LD patients experienced fewer serious infections (12% SIR-LD vs. 27% SIR-NLD, P=0.04) and a lower incidence of delayed graft function (21% SIR-LD vs. 39% SIR-NLD, P<0.05). No significant differences in serum creatinine, hemoglobin, and platelet counts occurred in the first 180 days posttransplantation, but the patients in the SIR-NLD group experienced lower hemoglobin levels at day 30 than those in the SIR-LD group (10.8 g/dL SIR-LD vs. 9.7 g/dL SIR-NLD, P=0.03). Conclusion. SIR-LD significantly improves early posttransplantation freedom from rejection in renal transplant recipients without increasing other complications.

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U2 - 10.1097/00007890-200301150-00016

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