A retrospective review of liver transplant patients treated with sirolimus from a single center: an analysis of sirolimus-related complications.

Marzia Montalbano, Guy W. Neff, Noriyo Yamashiki, Douglas Meyer, Marina Bettiol, Gabriella Slapak-Green, Phillip Ruiz, Emory Manten, Kamran Safdar, Christopher B O'Brien, Andreas G. Tzakis

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

BACKGROUND: Sirolimus (SRL) is a powerful immunosuppressant used primarily in calcineurin inhibitors (CNI)-related nephrotoxicity. However, reports of drug-related side effects are increasing. The aim of our report is to review the frequency and timing of these complications within our transplant patient population. METHODS: We retrospectively reviewed the medical records of liver-transplanted patients treated with sirolimus between November 1998 and April 2002. The data collected included SRL serum levels, frequency of reported and documented SRL-related side effects, and survival outcomes. Statistical evaluation included Pearson chi-square and the Fisher's exact tests. RESULTS: Overall, 205 patients were identified, with 30 patients removed from the analysis for different reasons. Of the remaining 175 patients, 91 (52%) patients developed a complication other than an increase in serum triglycerides and/or cholesterol. The most frequent complications were: bilateral lower extremity edema (57.1%), dermatitis (25.3%), oral ulcers (24.2%), joint pain (23.0%), pleural effusion (16.5%) and increase in abdominal girth (9.9%). Other complications included: generalized edema (5.5%), pericardial effusion (5.5%), facial edema (2.2%), and upper extremity edema (1.3%). In addition, we reported two cases of hepatic artery thrombosis, one case of wound dehiscence with evisceration that required surgical repair, and one case of skin cancer. Interestingly, we found that a previous history of myocardial ischemia correlates with the development of SRL side effects. CONCLUSIONS: SRL is a powerful immunosuppressant but not devoid of side effects. These results have elevated our level of suspicion when instituting SRL and may help with early recognition and prevention of drug related complications.

Original languageEnglish
Pages (from-to)264-268
Number of pages5
JournalTransplantation
Volume78
Issue number2
StatePublished - Jul 27 2004

Fingerprint

Sirolimus
Transplants
Liver
Edema
Immunosuppressive Agents
Oral Ulcer
Pericardial Effusion
Hepatic Artery
Arthralgia
Skin Neoplasms
Dermatitis
Pleural Effusion
Drug-Related Side Effects and Adverse Reactions
Serum
Upper Extremity
Medical Records
Myocardial Ischemia
Lower Extremity
Triglycerides
Thrombosis

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Montalbano, M., Neff, G. W., Yamashiki, N., Meyer, D., Bettiol, M., Slapak-Green, G., ... Tzakis, A. G. (2004). A retrospective review of liver transplant patients treated with sirolimus from a single center: an analysis of sirolimus-related complications. Transplantation, 78(2), 264-268.

A retrospective review of liver transplant patients treated with sirolimus from a single center : an analysis of sirolimus-related complications. / Montalbano, Marzia; Neff, Guy W.; Yamashiki, Noriyo; Meyer, Douglas; Bettiol, Marina; Slapak-Green, Gabriella; Ruiz, Phillip; Manten, Emory; Safdar, Kamran; O'Brien, Christopher B; Tzakis, Andreas G.

In: Transplantation, Vol. 78, No. 2, 27.07.2004, p. 264-268.

Research output: Contribution to journalArticle

Montalbano, M, Neff, GW, Yamashiki, N, Meyer, D, Bettiol, M, Slapak-Green, G, Ruiz, P, Manten, E, Safdar, K, O'Brien, CB & Tzakis, AG 2004, 'A retrospective review of liver transplant patients treated with sirolimus from a single center: an analysis of sirolimus-related complications.', Transplantation, vol. 78, no. 2, pp. 264-268.
Montalbano M, Neff GW, Yamashiki N, Meyer D, Bettiol M, Slapak-Green G et al. A retrospective review of liver transplant patients treated with sirolimus from a single center: an analysis of sirolimus-related complications. Transplantation. 2004 Jul 27;78(2):264-268.
Montalbano, Marzia ; Neff, Guy W. ; Yamashiki, Noriyo ; Meyer, Douglas ; Bettiol, Marina ; Slapak-Green, Gabriella ; Ruiz, Phillip ; Manten, Emory ; Safdar, Kamran ; O'Brien, Christopher B ; Tzakis, Andreas G. / A retrospective review of liver transplant patients treated with sirolimus from a single center : an analysis of sirolimus-related complications. In: Transplantation. 2004 ; Vol. 78, No. 2. pp. 264-268.
@article{1abb246c8fb1445188f8a59ea51ae656,
title = "A retrospective review of liver transplant patients treated with sirolimus from a single center: an analysis of sirolimus-related complications.",
abstract = "BACKGROUND: Sirolimus (SRL) is a powerful immunosuppressant used primarily in calcineurin inhibitors (CNI)-related nephrotoxicity. However, reports of drug-related side effects are increasing. The aim of our report is to review the frequency and timing of these complications within our transplant patient population. METHODS: We retrospectively reviewed the medical records of liver-transplanted patients treated with sirolimus between November 1998 and April 2002. The data collected included SRL serum levels, frequency of reported and documented SRL-related side effects, and survival outcomes. Statistical evaluation included Pearson chi-square and the Fisher's exact tests. RESULTS: Overall, 205 patients were identified, with 30 patients removed from the analysis for different reasons. Of the remaining 175 patients, 91 (52{\%}) patients developed a complication other than an increase in serum triglycerides and/or cholesterol. The most frequent complications were: bilateral lower extremity edema (57.1{\%}), dermatitis (25.3{\%}), oral ulcers (24.2{\%}), joint pain (23.0{\%}), pleural effusion (16.5{\%}) and increase in abdominal girth (9.9{\%}). Other complications included: generalized edema (5.5{\%}), pericardial effusion (5.5{\%}), facial edema (2.2{\%}), and upper extremity edema (1.3{\%}). In addition, we reported two cases of hepatic artery thrombosis, one case of wound dehiscence with evisceration that required surgical repair, and one case of skin cancer. Interestingly, we found that a previous history of myocardial ischemia correlates with the development of SRL side effects. CONCLUSIONS: SRL is a powerful immunosuppressant but not devoid of side effects. These results have elevated our level of suspicion when instituting SRL and may help with early recognition and prevention of drug related complications.",
author = "Marzia Montalbano and Neff, {Guy W.} and Noriyo Yamashiki and Douglas Meyer and Marina Bettiol and Gabriella Slapak-Green and Phillip Ruiz and Emory Manten and Kamran Safdar and O'Brien, {Christopher B} and Tzakis, {Andreas G.}",
year = "2004",
month = "7",
day = "27",
language = "English",
volume = "78",
pages = "264--268",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - A retrospective review of liver transplant patients treated with sirolimus from a single center

T2 - an analysis of sirolimus-related complications.

AU - Montalbano, Marzia

AU - Neff, Guy W.

AU - Yamashiki, Noriyo

AU - Meyer, Douglas

AU - Bettiol, Marina

AU - Slapak-Green, Gabriella

AU - Ruiz, Phillip

AU - Manten, Emory

AU - Safdar, Kamran

AU - O'Brien, Christopher B

AU - Tzakis, Andreas G.

PY - 2004/7/27

Y1 - 2004/7/27

N2 - BACKGROUND: Sirolimus (SRL) is a powerful immunosuppressant used primarily in calcineurin inhibitors (CNI)-related nephrotoxicity. However, reports of drug-related side effects are increasing. The aim of our report is to review the frequency and timing of these complications within our transplant patient population. METHODS: We retrospectively reviewed the medical records of liver-transplanted patients treated with sirolimus between November 1998 and April 2002. The data collected included SRL serum levels, frequency of reported and documented SRL-related side effects, and survival outcomes. Statistical evaluation included Pearson chi-square and the Fisher's exact tests. RESULTS: Overall, 205 patients were identified, with 30 patients removed from the analysis for different reasons. Of the remaining 175 patients, 91 (52%) patients developed a complication other than an increase in serum triglycerides and/or cholesterol. The most frequent complications were: bilateral lower extremity edema (57.1%), dermatitis (25.3%), oral ulcers (24.2%), joint pain (23.0%), pleural effusion (16.5%) and increase in abdominal girth (9.9%). Other complications included: generalized edema (5.5%), pericardial effusion (5.5%), facial edema (2.2%), and upper extremity edema (1.3%). In addition, we reported two cases of hepatic artery thrombosis, one case of wound dehiscence with evisceration that required surgical repair, and one case of skin cancer. Interestingly, we found that a previous history of myocardial ischemia correlates with the development of SRL side effects. CONCLUSIONS: SRL is a powerful immunosuppressant but not devoid of side effects. These results have elevated our level of suspicion when instituting SRL and may help with early recognition and prevention of drug related complications.

AB - BACKGROUND: Sirolimus (SRL) is a powerful immunosuppressant used primarily in calcineurin inhibitors (CNI)-related nephrotoxicity. However, reports of drug-related side effects are increasing. The aim of our report is to review the frequency and timing of these complications within our transplant patient population. METHODS: We retrospectively reviewed the medical records of liver-transplanted patients treated with sirolimus between November 1998 and April 2002. The data collected included SRL serum levels, frequency of reported and documented SRL-related side effects, and survival outcomes. Statistical evaluation included Pearson chi-square and the Fisher's exact tests. RESULTS: Overall, 205 patients were identified, with 30 patients removed from the analysis for different reasons. Of the remaining 175 patients, 91 (52%) patients developed a complication other than an increase in serum triglycerides and/or cholesterol. The most frequent complications were: bilateral lower extremity edema (57.1%), dermatitis (25.3%), oral ulcers (24.2%), joint pain (23.0%), pleural effusion (16.5%) and increase in abdominal girth (9.9%). Other complications included: generalized edema (5.5%), pericardial effusion (5.5%), facial edema (2.2%), and upper extremity edema (1.3%). In addition, we reported two cases of hepatic artery thrombosis, one case of wound dehiscence with evisceration that required surgical repair, and one case of skin cancer. Interestingly, we found that a previous history of myocardial ischemia correlates with the development of SRL side effects. CONCLUSIONS: SRL is a powerful immunosuppressant but not devoid of side effects. These results have elevated our level of suspicion when instituting SRL and may help with early recognition and prevention of drug related complications.

UR - http://www.scopus.com/inward/record.url?scp=8744256458&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=8744256458&partnerID=8YFLogxK

M3 - Article

C2 - 15280688

AN - SCOPUS:8744256458

VL - 78

SP - 264

EP - 268

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 2

ER -