Literature DB >> 24782689

Postoperative complications associated with perioperative sirolimus prior to pediatric cardiac retransplantation.

Jason F Goldberg1, Aamir Jeewa1, William J Dreyer1, Gerald J Adams1, Antonio G Cabrera1, Jack F Price1, Jeffrey S Heinle1, Susan W Denfield1.   

Abstract

OBJECTIVES: Sirolimus has been used in pediatric cardiac transplantation for the past decade for chronic renal dysfunction, recurrent rejection, and/or coronary allograft vasculopathy. There has been concern regarding the effect of sirolimus on wound healing and other postoperative complications. To date, the pediatric literature on its use is limited and has not specifically addressed its use in the perioperative period following repeat cardiac transplantation.
METHODS: We compared the patients in our institution who received sirolimus before repeat cardiac transplantation to those in the same era who did not receive sirolimus.
RESULTS: Of the 5 patients in the study group, 5 (100%) developed pleural effusions vs 1 (17%) in the control group (p=0.013). There was no increase in mortality in the sirolimus group, and there were no significant differences in renal dysfunction, serious bacterial infection, rejection, or postoperative length of stay.
CONCLUSIONS: In this small data set, there was a statistically significant increase in pleural effusions in patients on sirolimus. Further study is needed to develop an appropriate strategy to avoid postoperative complications in this patient population.

Entities:  

Keywords:  heart transplantation; pediatrics; postoperative complications; sirolimus

Year:  2014        PMID: 24782689      PMCID: PMC3998965          DOI: 10.5863/1551-6776-19.1.30

Source DB:  PubMed          Journal:  J Pediatr Pharmacol Ther        ISSN: 1551-6776


  15 in total

1.  The Registry of the International Society for Heart and Lung Transplantation: Fourteenth Pediatric Lung and Heart-Lung Transplantation Report--2011.

Authors:  Christian Benden; Paul Aurora; Leah B Edwards; Anna Y Kucheryavaya; Jason D Christie; Fabienne Dobbels; Richard Kirk; Axel O Rahmel; Josef Stehlik; Marshall I Hertz
Journal:  J Heart Lung Transplant       Date:  2011-10       Impact factor: 10.247

2.  Early renal benefit of rapamycin combined with reduced calcineurin inhibitor dose in pediatric heart transplantation patients.

Authors:  Ian C Balfour; Sopheak W Srun; Ellen G Wood; Craig W Belsha; Donna L Marshall; Barbara R Ferdman
Journal:  J Heart Lung Transplant       Date:  2006-05       Impact factor: 10.247

3.  Calcineurin inhibitor minimization using sirolimus leads to improved renal function in pediatric heart transplant recipients.

Authors:  Timothy J Chinnock; Tamara Shankel; Douglas Deming; Drew Cutler; Shobha Sahney; James Fitts; Richard E Chinnock
Journal:  Pediatr Transplant       Date:  2011-08-23

4.  Improvement of renal dysfunction by conversion from calcineurin inhibitors to sirolimus after heart transplantation.

Authors:  Judson Hunt; Mark Lerman; Mitchell J Magee; Todd M Dewey; Morley Herbert; Michael J Mack
Journal:  J Heart Lung Transplant       Date:  2005-06-13       Impact factor: 10.247

5.  Indications, tolerance and complications of a sirolimus and calcineurin inhibitor immunosuppression regimen: intermediate experience in pediatric heart transplantation recipients.

Authors:  Kathleen Matthews; Jeffrey Gossett; Peter Vande Kappelle; Gina Jellen; Elfriede Pahl
Journal:  Pediatr Transplant       Date:  2010-03-08

6.  Sirolimus immunosuppression in pediatric heart transplant recipients: a single-center experience.

Authors:  Natalia E Lobach; Stacey M Pollock-Barziv; Lori J West; Anne I Dipchand
Journal:  J Heart Lung Transplant       Date:  2005-02       Impact factor: 10.247

7.  Wound healing complications with de novo sirolimus versus mycophenolate mofetil-based regimen in cardiac transplant recipients.

Authors:  S Kuppahally; A Al-Khaldi; D Weisshaar; H A Valantine; P Oyer; R C Robbins; S A Hunt
Journal:  Am J Transplant       Date:  2006-05       Impact factor: 8.086

8.  Conversion to sirolimus as primary immunosuppression attenuates the progression of allograft vasculopathy after cardiac transplantation.

Authors:  Eugenia Raichlin; Jang-Ho Bae; Zain Khalpey; Brooks S Edwards; Walter K Kremers; Alfredo L Clavell; Richard J Rodeheffer; Robert P Frantz; Charanjit Rihal; Amir Lerman; Sudhir S Kushwaha
Journal:  Circulation       Date:  2007-11-19       Impact factor: 29.690

9.  Modified RIFLE criteria in critically ill children with acute kidney injury.

Authors:  A Akcan-Arikan; M Zappitelli; L L Loftis; K K Washburn; L S Jefferson; S L Goldstein
Journal:  Kidney Int       Date:  2007-03-28       Impact factor: 10.612

10.  Surgical wound-healing complications in heart transplant recipients treated with rapamycin.

Authors:  Michael Zakliczynski; Jerzy Nozynski; Alfred Kocher; Maria K Lizak; Helena Zakliczynska; Roman Przybylski; Jacek Wojarski; Marian Zembala
Journal:  Wound Repair Regen       Date:  2007 May-Jun       Impact factor: 3.617

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  1 in total

1.  Safety of mTOR inhibitor continuation in pediatric heart transplant recipients undergoing surgical procedures.

Authors:  Ann Heble; Melanie D Everitt; Jane Gralla; Shelley D Miyamoto; Michael Lahart; Jennifer Eshelman
Journal:  Pediatr Transplant       Date:  2017-12-06
  1 in total

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