697: Aggressive Medical Therapy Can Control the Hyperlipidemia Associated with Sirolimus Utilization after Cardiac Transplantation

Shullo, M.; Zomak, R.; Yost, C.; Rebel, M.; Newman, Christine; Bermúdez, C.; McNamara, Dennis M.; Kormos, Robert L.; Teuteberg, Jeffrey J.

doi:10.1016/j.healun.2008.11.704

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“…It has been previously reported sirolimus can raise cholesterol and triglyceride levels and this group of patients covered a time period of several treatment strategies of lipid management, and thus, sufficient lipid data were not available for many of the patients converted prior to the year 2000. In addition, we have previously demonstrated that excellent lipid control can be maintained after a conversion to sirolimus (27). Evidence is now emerging that sirolimus can lead to significant proteinuria and the renal benefit is greatest in patients prior to the development of proteinuria (28).…”

Section: Discussionmentioning

confidence: 99%

Long‐term effects on renal function of dose‐reduced calcineurin inhibitor and sirolimus in cardiac transplant patients

Khandhar

Shah

Shullo

et al. 2011

Clinical Transplantation

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One hundred and fifty-five patients (79 sirolimus and 76 controls) were included and had similar baseline characteristics. Sirolimus was started a mean of 1429 d post-CTX and maintained for a mean of 823 d. Reason for conversion to sirolimus was renal insufficiency (34%), vasculopathy (29%), recurrent rejection (19%), and other (18%). The eGFR was not different between groups at baseline (44.7 mL/min/1.73 m(2) vs. 46.0, p = 0.64) or at any point during follow-up: 90 d, 180 d, 1 yr, 2 yr, and 3 yr. conclusion: Patients converted to a regimen of sirolimus and a dosed-reduced CNI have stable renal function over the following three yr, but do not have an improvement in renal outcomes compared to patients maintained on full dose CNI.

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Section: Discussionmentioning

confidence: 99%