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Sirolimus Conversion Efficacy for Graft Function Improvement and Histopathology in Renal Recipients with Mild to Moderate Renal Insufficiency

 Dong Jin Joo  ;  Chul Woo Yang  ;  Hyeon Joo Jeong  ;  Beom Jin Lim  ;  Kyu Ha Huh  ;  Byung Ha Chung  ;  Yeong Jin Choi  ;  Shin-Wook Kang  ;  Yu Seun Kim 
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.29(8) : 1069-1076, 2014 
Journal Title
Issue Date
Adult ; Calcineurin Inhibitors/administration & dosage* ; Drug Synergism ; Female ; Graft Rejection/etiology* ; Graft Rejection/prevention & control* ; Graft Survival/drug effects ; Humans ; Immunosuppressive Agents ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods* ; Male ; Renal Insufficiency/diagnosis ; Renal Insufficiency/therapy* ; Republic of Korea ; Severity of Illness Index ; Sirolimus/administration & dosage* ; Transplantation Tolerance/drug effects ; Treatment Outcome
Calcineurin Inhibitor ; Kidney Transplantation ; Renal Function ; Renal Impairment ; Sirolimus
This study was designed to evaluate whether sirolimus (SRL) conversion effectively improves renal function and histopathology in calcineurin inhibitor (CNI)-treated renal recipients with mild to moderate renal insufficiency. SRL conversion from CNI was performed in patients who underwent kidney transplantation from 6 months to 5 yr prior to screening. Forty-five patients were enrolled. The effect of SRL conversion on graft function was evaluated, and protocol biopsies were performed preconversion and 1 yr after conversion. Overall graft function after SRL conversion gradually improved, and the improvement in renal function was closely associated with the shorter duration of CNI exposure. When we divided the patients by the duration of CNI exposure, the patients with less than 1 yr of CNI exposure demonstrated significant improvement, but patients with a greater than 1 yr CNI exposure did not exhibit significant improvement. In contrast, protocol biopsies demonstrated no significant improvements in the modified "ah" score or other Banff scores after SRL conversion. Furthermore, the duration of CNI treatment prior to SRL conversion was not associated with histological findings 1 yr after SRL conversion. SRL conversion improved graft function in renal recipients with mild to moderate renal insufficiency, but this effect is not accompanied by histological improvement.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Lim, Beom Jin(임범진) ORCID logo https://orcid.org/0000-0003-2856-0133
Jeong, Hyeon Joo(정현주) ORCID logo https://orcid.org/0000-0002-9695-1227
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
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