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Sirolimus-induced pneumonitis after renal transplantation: a single-center experience

Authors
 H.S. Lee  ;  K.H. Huh  ;  Y.S. Kim  ;  M.S. Kim  ;  H.J. Kim  ;  S.I. Kim  ;  D.J. Joo 
Citation
 Transplantation Proceedings, Vol.44(1) : 161-163, 2012 
Journal Title
 Transplantation Proceedings 
ISSN
 0041-1345 
Issue Date
2012
Abstract
PURPOSE: Sirolimus is a potent immunosuppressive agent used with increasing frequency in kidney transplantation. However, sirolimus can increase the rate of unexplained interstitial pneumonitis. The aim of this study was to evaluate the clinical characteristics of sirolimus-induced pneumonitis and the therapeutic results in renal transplant recipients. PATIENTS AND METHODS: Seventy-two patients received sirolimus, conversion or de novo regimen, at our center between January 2007 and April 2011. Twelve of the 72 patients (16.7%) developed interstitial pneumonitis. The patients were divided into three groups according to the following indications of sirolimus use: de novo, early conversion, and late conversion groups. RESULTS: The mean duration of follow-up was 11.0 ± 11.5 months. The mean blood level of sirolimus measured by microparticulate enzyme immunoassay was 16.5 ± 7.4 ng/mL at the time of diagnosis. The mean time from the start of sirolimus to pneumonitis onset was 14.7 ± 8.0 months. The clinical presentation included fever, cough, dyspnea, general weakness, and periorbital edema. In most cases, radiological imaging tests revealed bilateral lower-lobe involvement. Bronchoalveolar lavage was performed in three patients and two patients showed lymphocytic alveolitis. Sirolimus was discontinued or reduced for the treatment of pneumonitis. All cases of pneumonitis were resolved within 2 to 4 weeks. CONCLUSION: Sirolimus blood level should be monitored tightly and early intervention is important when sirolimus-induced pneumonitis is suspected.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91953
DOI
10.1016/j.transproceed.2011.11.059
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김명수(Kim, Myoung Soo) ; 김순일(Kim, Soon Il) ; 김유선(Kim, Yu Seun) ; 이형근(Lee, Hyung Keun) ; 주동진(Joo, Dong Jin) ; 허규하(Huh, Kyu Ha)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0041134511016563
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