PMID- 27293553
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160613
LR  - 20231105
IS  - 2047-1440 (Print)
IS  - 2047-1440 (Electronic)
IS  - 2047-1440 (Linking)
VI  - 4
IP  - Suppl 1
DP  - 2015
TI  - Reviewing 15 years of experience with sirolimus.
PG  - 6
LID - 10.1186/s13737-015-0028-6 [doi]
LID - 6
AB  - Here, we review 15 years of clinical use of sirolimus in our transplant center, 
      in context with the developing immunosuppressive strategies use worldwide. The 
      majority of studies were conducted in de novo kidney transplant recipients, using 
      sirolimus (SRL) in combination with calcineurin inhibitors (CNIs). We also 
      explored steroid (ST) or CNI-sparing therapies, including CNI minimization, 
      elimination, or conversion strategies in combination with mycophenolate 
      (MMF/MPS). Pooled long-term outcomes were comparable with those obtained with CNI 
      and antimetabolite combination. Surprisingly, there are still several areas that 
      need further investigation to improve the risk/benefit profile of SRL in kidney 
      transplantation, including pharmacokinetic/pharmacodynamic drug-to-drug 
      interaction with cyclosporine (CsA) or tacrolimus (TAC), mechanisms of 
      SRL-associated adverse reactions and combinations with other drugs such as 
      belatacept and once-daily TAC, possibly leading to improved long-term adherence. 
      These studies, along with others investigating the benefits of SRL associated 
      lower viral infections and malignancies, are essential as we do not expect the 
      introduction of new immunosuppressive drugs in the near future.
FAU - Tedesco Silva, Helio Jr
AU  - Tedesco Silva H Jr
AD  - Nephrology Division, Hospital do Rim, Escola Paulista de Medicina, Universidade 
      Federal de Sao Paulo, Sao Paulo, Brazil.
FAU - Rosso Felipe, Claudia
AU  - Rosso Felipe C
AD  - Nephrology Division, Hospital do Rim, Escola Paulista de Medicina, Universidade 
      Federal de Sao Paulo, Sao Paulo, Brazil.
FAU - Medina Pestana, Jose Osmar
AU  - Medina Pestana JO
AD  - Nephrology Division, Hospital do Rim, Escola Paulista de Medicina, Universidade 
      Federal de Sao Paulo, Sao Paulo, Brazil.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151222
PL  - England
TA  - Transplant Res
JT  - Transplantation research
JID - 101597592
PMC - PMC4895289
EDAT- 2015/01/01 00:00
MHDA- 2015/01/01 00:01
PMCR- 2015/12/22
CRDT- 2016/06/14 06:00
PHST- 2016/06/14 06:00 [entrez]
PHST- 2015/01/01 00:00 [pubmed]
PHST- 2015/01/01 00:01 [medline]
PHST- 2015/12/22 00:00 [pmc-release]
AID - 28 [pii]
AID - 10.1186/s13737-015-0028-6 [doi]
PST - epublish
SO  - Transplant Res. 2015 Dec 22;4(Suppl 1):6. doi: 10.1186/s13737-015-0028-6. 
      eCollection 2015.