2010 - TTS International Congress


This page contains exclusive content for the member of the following sections: TTS. Log in to view.

Clinical Immunosuppression Kidney early

22.21 - Impact of Sirolimus and Calcineurin Inhibitors on Carotis Intima-Media Thickness and Atherosclerotic Plaque Formation in Renal Transplant Patients: A Prospective Study

Presenter: Julide, Sagiroglu, Fulya, Sisli, Turkey
Authors: Sagiroglu J., Tellioglu G., Bozdereli A., Erdogrul G., Canbakan M., Yılmaz N., Titiz I.

IMPACT OF SIROLIMUS AND CALCINEURIN INHIBITORS ON CAROTIS INTIMA-MEDIA THICKNESS AND ATHEROSCLEROTIC PLAQUE FORMATION IN RENAL TRANSPLANT PATIENTS: A PROSPECTIVE STUDY

CLINICAL IMMUNOSUPPRESSION - KIDNEY EARLY

J. Sagiroglu1, G. Tellioglu1, A. Bozdereli1, G. Erdogrul2, M. Canbakan3, N. Yılmaz4, I.M. Titiz1
1, Haydarpasa Numune Research and Training Hospital, ?stanbul/TURKEY, 2General Surgery And Transplantation Clinic, Haydarpasa Numune Research and Training Hospital, ?stanbul/TURKEY, 3Nephrology Department, Haydarpasa Numune Research and Training Hospital, ?stanbul/TURKEY, 4Internal Medicine, University of Mugla Faculty of Medicine, Mugla/TURKEY

Body: Introduction: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity for renal transplant recipients after renal transplantation. This study is aimed to assess and compare the effects of sirolimus (SRL) and calcineurin inhibitors (CNIs) on the progression of posttransplant atherosclerosis prospectively . Methods: The study included 82 renal transplant recipients operated between 2004-2006. Bilateral B mode arterial carotis Doppler ultrasound was performed pretransplant and in follow-up during posttransplant 3 years for detection of the changes in arterial intima-media thickness (IMT) and atherosclerotic plaque dimensions in the carotid arteries. Time points for Doppler ultrasound performance were as follows; one week before the operation and 3, 6, 12, 24 and 36 months posttransplant. IL-2 receptor blockade was not used routinely. Selection for IL-2 receptor blockade usage was based on the history of immunosensitization and similar doses were administered. Outcome analysis was based on the comparison of the immunosuppressive regimen including SRL and CNIs (sirolimus, n=20, tacrolimus (TAC), n=31, cyclosporin A (CsA), n=31). Mycophenolate mofetil and steroids were adjunctive immunosuppressive drugs and used in similar doses in each group. Results: Patient characteristics were similar regarding mean age, duration of renal replacement therapy and the type of replacement therapy prior to the transplantation, family history of cardiovascular disease and presence of diabetes mellitus type I and II (p>0.05). Serum LDL levels were significantly higher in SRL group during post-transplant follow-up (p<0.05). No graft loss was recorded during the study period. Mean serum creatinine levels at the last follow-up were 1,03+0,3 mg/dl, 1,3+0,3 mg/dl, 1,1+0,1 mg/dl in SRL, TAC and CsA groups respectively. Number of acute rejection episodes (biopsy proven) were 5, 2, 2 in SRL, TAC and CsA respectively and the differences were not statistically significant. Biopsy proven acute rejection episodes were slightly higher in the SRL group but this was not statistically significant (p>0,05). Although did not reach a statistically significant level patients in SRL group showed tendency to decreased carotid plaque dimensions where TAC and CsA increased the plaque progression and this difference was not statistically significant (p>0,05). Conclusion: SRL seems to reverse the progression of atherosclerosis and thereby possibly produce a risk reduction of CVD following renal transplantation when compared to TAC and CsA. Longer follow-up may clarify the benefit of SRL with regard to CVD related to immunosuppressive treatment in renal transplantation. Key words: Sirolimus; calcineurin inhibitors; atherosclerosis; renal transplantation; ultrasonography; cardiovascular disease

Disclosure: All authors have declared no conflicts of interest.


Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.

Social

Contact

Staff Directory
+1-514-874-1717
info@tts.org

Address

The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada