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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Conversion From Sirolimus to Everolimus in Long-Term Liver Graft Recipients
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Conversion From Sirolimus to Everolimus in Long-Term Liver Graft Recipients

机译：从Sirolimus转化为长期肝脏移植受者的血偶司

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Immunosuppression by inhibition of the mechanistic target of rapamycin (mTOR) is a promising approach after liver transplantation. The mTOR inhibitor sirolimus was used in selected liver graft recipients despite safety concerns and lack of approval. Everolimus is another mTOR inhibitor approved after liver transplantation. It is currently unknown, whether conversion of sirolimus to everolimus is safe in long-term liver graft recipients. Long-term liver graft recipients treated with sirolimus were converted to everolimus. A systematical analysis of biochemical and clinical data before and after conversion was performed. Sixteen patients were included (female/male, 8/8). Median (range) age at conversion was 66 years (49-78 years), and patients were converted at a median (range) of 10.1 years (4.0-22.3 years) after liver transplantation. In the majority of patients, no dose adjustment was needed after conversion. No rejection and no cytomegalovirus replication episodes were observed. Furthermore, no differences were found with respect to kidney function, diabetes mellitus, or blood pressure before and after conversion. Bilirubin serum concentration was lower, whereas aspartateaminotransaminase, alanineaminotransferase, and triglycerides serum concentrations were higher after conversion to everolimus. Neither clinical- nor graft-associated significant complications were observed after conversion from sirolimus to everolimus in long-term liver graft recipients. Everolimus-based immunosuppression may be offered to patients after liver transplantation formerly treated with sirolimus.
机译：通过抑制雷帕霉素（mTOR）的机制靶点进行免疫抑制是肝移植术后一种很有前途的方法。mTOR抑制剂西罗莫司用于选定的肝移植受者，尽管存在安全性问题且缺乏批准。依维莫司是肝移植后批准的另一种mTOR抑制剂。目前尚不清楚长期肝移植受者将西罗莫司转换为依维莫司是否安全。长期接受西罗莫司治疗的肝移植受者转为依维莫司。对转换前后的生化和临床数据进行了系统分析。包括16名患者（女性/男性，8/8）。中位（范围）转诊年龄为66岁（49-78岁），患者在肝移植后转诊的中位（范围）为10.1年（4.0-22.3岁）。在大多数患者中，转换后无需调整剂量。未观察到排斥反应和巨细胞病毒复制事件。此外，在转换前后，在肾功能、糖尿病或血压方面没有发现差异。转换为依维莫司后，胆红素血清浓度较低，而天冬氨酸转氨酶、丙氨酸转氨酶和甘油三酯血清浓度较高。长期肝移植受者从西罗莫司转为依维莫司后，未观察到临床或移植物相关的显著并发症。以前使用西罗莫司治疗的肝移植后患者可能会接受以依维莫司为基础的免疫抑制。

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