Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátrico

Sirolimus (SRL) is a new immunosuppressive drug approved for renal transplantation, but is being used increasingly in orthotopic liver transplantation (OLT). Compared with the calcineurin inhibitors, SRL has different mechanisms of action and side effects profile. Thus, this drug offers significant...

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Autores principales:	Roque E,Jorge, Ríos M,Gloria, Hepp K,Juan, Humeres A,Roberto, Ríos R,Horacio, Herrera,José M, Rius A,Montserrat
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2005
Materias:	Liver transplantation Sirolimus Tacrolimus
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001000011
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spelling	oai:scielo:S0034-988720050010000112005-12-05Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátricoRoque E,JorgeRíos M,GloriaHepp K,JuanHumeres A,RobertoRíos R,HoracioHerrera,José MRius A,Montserrat Liver transplantation Sirolimus Tacrolimus Sirolimus (SRL) is a new immunosuppressive drug approved for renal transplantation, but is being used increasingly in orthotopic liver transplantation (OLT). Compared with the calcineurin inhibitors, SRL has different mechanisms of action and side effects profile. Thus, this drug offers significant potential advantages over other immunosuppressive agents. SRL does not cause glucose intolerance, hypertension or renal failure, but it may cause dyslipidemia, hepatic artery thrombosis, thrombocytopenia, anemia, leukopenia, oral mucosa ulcers, edema, arthralgias and wound complications. SRL inhibits the signal of interleukin 2 at a post-receptor level, inhibiting lymphocyte proliferation and fibroblast proliferation. It also has antineoplastic and antifungal effects. We report a 10 years old girl who underwent OLT, experiencing a biopsy-proven recurrent acute rejection (AR) in spite of using three immunosuppressive agents (tacrolimus, mofetil micofenolate and steroids). She developed diabetes mellitus as a consequence of the immunosuppressive therapy. She was rescued with SRL, not experiencing AR again. Mofetil micofenolate, steroids and insulin could be discontinued and tacrolimus doses were reduced, without experiencing severe complications. SRL is a new and safe immunosuppressive agent for rescue in patients with OLT and recurrent AR (Rev Méd Chile 2005; 133: 1221-4)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.10 20052005-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001000011es10.4067/S0034-98872005001000011
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Liver transplantation Sirolimus Tacrolimus
spellingShingle	Liver transplantation Sirolimus Tacrolimus Roque E,Jorge Ríos M,Gloria Hepp K,Juan Humeres A,Roberto Ríos R,Horacio Herrera,José M Rius A,Montserrat Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátrico
description	Sirolimus (SRL) is a new immunosuppressive drug approved for renal transplantation, but is being used increasingly in orthotopic liver transplantation (OLT). Compared with the calcineurin inhibitors, SRL has different mechanisms of action and side effects profile. Thus, this drug offers significant potential advantages over other immunosuppressive agents. SRL does not cause glucose intolerance, hypertension or renal failure, but it may cause dyslipidemia, hepatic artery thrombosis, thrombocytopenia, anemia, leukopenia, oral mucosa ulcers, edema, arthralgias and wound complications. SRL inhibits the signal of interleukin 2 at a post-receptor level, inhibiting lymphocyte proliferation and fibroblast proliferation. It also has antineoplastic and antifungal effects. We report a 10 years old girl who underwent OLT, experiencing a biopsy-proven recurrent acute rejection (AR) in spite of using three immunosuppressive agents (tacrolimus, mofetil micofenolate and steroids). She developed diabetes mellitus as a consequence of the immunosuppressive therapy. She was rescued with SRL, not experiencing AR again. Mofetil micofenolate, steroids and insulin could be discontinued and tacrolimus doses were reduced, without experiencing severe complications. SRL is a new and safe immunosuppressive agent for rescue in patients with OLT and recurrent AR (Rev Méd Chile 2005; 133: 1221-4)
author	Roque E,Jorge Ríos M,Gloria Hepp K,Juan Humeres A,Roberto Ríos R,Horacio Herrera,José M Rius A,Montserrat
author_facet	Roque E,Jorge Ríos M,Gloria Hepp K,Juan Humeres A,Roberto Ríos R,Horacio Herrera,José M Rius A,Montserrat
author_sort	Roque E,Jorge
title	Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátrico
title_short	Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátrico
title_full	Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátrico
title_fullStr	Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátrico
title_full_unstemmed	Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátrico
title_sort	rescate con sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: caso clínico pediátrico
publisher	Sociedad Médica de Santiago
publishDate	2005
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001000011
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Rescate con Sirolimus por rechazo agudo recurrente y diabetes mellitus en trasplante hepático: Caso clínico pediátrico

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