INTRODUCTION: Mammalian target rapamycin inhibitors (m-TORi) are increasingly used in patients undergoing liver transplantation (LT). Yet, there is rising concern that they also could impair wound healing and favor the development of several surgical complications. This report was designed to evaluate both feasibility and safety of major surgery in liver transplant recipients receiving m-TORi-based immunosuppression without therapeutic discontinuation. METHODS: From 2007 to 2012, six liver transplant recipients underwent nine major abdominal or thoracic surgical procedures without m-TORi discontinuation or specific dosage adjustment. Their characteristics and postoperative outcomes were retrospectively analyzed. RESULTS: Indications for m-TORi were de novo or recurrent malignant disease in five patients and calcineurin inhibitors related neurologic toxicity in one patient. Abdominal procedures, thoracic procedures, and combined thoracic and abdominal procedures were performed in six, two, and one cases respectively. Emergency surgery was performed in one case and elective procedures were performed in eight cases, including five for malignant disease and three for late surgical complications following LT. No patient died postoperatively. One major complication was observed, but no patient required reoperation. No evisceration, incisional surgical site infection, or lymphocele occurred. CONCLUSIONS: Major surgery in liver transplant recipients receiving m-TOR inhibitors appears both feasible and safe without therapeutic discontinuation or specific dosage adjustment.
INTRODUCTION:Mammalian target rapamycin inhibitors (m-TORi) are increasingly used in patients undergoing liver transplantation (LT). Yet, there is rising concern that they also could impair wound healing and favor the development of several surgical complications. This report was designed to evaluate both feasibility and safety of major surgery in liver transplant recipients receiving m-TORi-based immunosuppression without therapeutic discontinuation. METHODS: From 2007 to 2012, six liver transplant recipients underwent nine major abdominal or thoracic surgical procedures without m-TORi discontinuation or specific dosage adjustment. Their characteristics and postoperative outcomes were retrospectively analyzed. RESULTS: Indications for m-TORi were de novo or recurrent malignant disease in five patients and calcineurin inhibitors related neurologic toxicity in one patient. Abdominal procedures, thoracic procedures, and combined thoracic and abdominal procedures were performed in six, two, and one cases respectively. Emergency surgery was performed in one case and elective procedures were performed in eight cases, including five for malignant disease and three for late surgical complications following LT. No patient died postoperatively. One major complication was observed, but no patient required reoperation. No evisceration, incisional surgical site infection, or lymphocele occurred. CONCLUSIONS: Major surgery in liver transplant recipients receiving m-TOR inhibitors appears both feasible and safe without therapeutic discontinuation or specific dosage adjustment.
Authors: Panagiotis Fikatas; Wentzel Schoening; Ji-Eun Lee; Sascha Santosh Chopra; Daniel Seehofer; Olaf Guckelberger; Gero Puhl; Peter Neuhaus; Sven C Schmidt Journal: Ann Transplant Date: 2013-05-16 Impact factor: 1.530
Authors: Patrick G Dean; William J Lund; Timothy S Larson; Mikel Prieto; Scott L Nyberg; Michael B Ishitani; Walter K Kremers; Mark D Stegall Journal: Transplantation Date: 2004-05-27 Impact factor: 4.939
Authors: Nissreen Elfadawy; Stuart M Flechner; Xiaobo Liu; Jesse Schold; Devin Tian; Titte R Srinivas; Emilio Poggio; Richard Fatica; Robin Avery; Sherif B Mossad Journal: Transpl Int Date: 2013-06-14 Impact factor: 3.782
Authors: Giuseppe Tarantino; Paolo Magistri; Roberto Ballarin; Raffaele Di Francia; Massimiliano Berretta; Fabrizio Di Benedetto Journal: Front Pharmacol Date: 2016-10-21 Impact factor: 5.810
Authors: Muhammad Abdul Mabood Khalil; Saeed M G Al-Ghamdi; Ubaidullah Shaik Dawood; Said Sayed Ahmed Khamis; Hideki Ishida; Vui Heng Chong; Jackson Tan Journal: J Transplant Date: 2022-02-28