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The use of sirolimus in patients with recurrent cytomegalovirus infection after kidney transplantation : a retrospective case series analysis
Joint Authors
Shindi, Ali M.
Hung, Rachel K. Y.
Caplin, Ben
Griffiths, Paul
Harber, Mark
Source
Saudi Journal of Kidney Diseases and Transplantation
Issue
Vol. 30, Issue 3 (30 Jun. 2019), pp.606-614, 9 p.
Publisher
Saudi Center for Organ Transplantation
Publication Date
2019-06-30
Country of Publication
Saudi Arabia
No. of Pages
9
Main Subjects
Topics
Abstract EN
Cytomegalovirus (CMV) is one of opportunistic infections post solid organ transplant and remains a cause of morbidity and mortality.
Mammalian target of rapamycin inhibitors has a theoretical antiviral advantage compared to conventional immunosuppression.
The primary outcome was to assess the viremic response and kidney function in a cohort of kidney transplant recipients (KTRs) with difficult to manage CMV infection when converted to sirolimus.
We retrospectively analyzed the outcome of substituting sirolimus for mycophenolate mofetil (MMF) or tacrolimus in 18 KTR with difficult to manage, resistant / recurrent CMV viremia unresponsive or intolerant of standard anti-CMV treatment, or immunosuppression reduction.
Safety and feasibility of sirolimus conversion were assessed through studying CMV viral loads, creatinine levels, immunosuppression, antiviral therapy, kidney function, and acute rejection episodes before and after starting sirolimus as well as the sirolimus side effects.
Data were collected from the hospital filing system.
The Wilcoxon matched-pairs signed-rank test and Friedman test were used for statistical analysis.
The area under the curve for Log10 CMV viral load (log10 copies/ml) was significantly higher before than after the sirolimus switch (P = 0.0156).
The median number of days on antiviral treatment was reduced after conversion to sirolimus [48 days (0–95) ; vs.
68 days (21–146)].
Acute rejection occurred more commonly before than after starting sirolimus [n = 5 (27.7 %) vs.
n = 2 (11.1 %)].
Median serum creatinine
American Psychological Association (APA)
Shindi, Ali M.& Hung, Rachel K. Y.& Caplin, Ben& Griffiths, Paul& Harber, Mark. 2019. The use of sirolimus in patients with recurrent cytomegalovirus infection after kidney transplantation : a retrospective case series analysis. Saudi Journal of Kidney Diseases and Transplantation،Vol. 30, no. 3, pp.606-614.
https://search.emarefa.net/detail/BIM-894121
Modern Language Association (MLA)
Shindi, Ali M.…[et al.]. The use of sirolimus in patients with recurrent cytomegalovirus infection after kidney transplantation : a retrospective case series analysis. Saudi Journal of Kidney Diseases and Transplantation Vol. 30, no. 3 (May. / Jun. 2019), pp.606-614.
https://search.emarefa.net/detail/BIM-894121
American Medical Association (AMA)
Shindi, Ali M.& Hung, Rachel K. Y.& Caplin, Ben& Griffiths, Paul& Harber, Mark. The use of sirolimus in patients with recurrent cytomegalovirus infection after kidney transplantation : a retrospective case series analysis. Saudi Journal of Kidney Diseases and Transplantation. 2019. Vol. 30, no. 3, pp.606-614.
https://search.emarefa.net/detail/BIM-894121
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 613-614
Record ID
BIM-894121