CME on Transplantation is dedicated to online CME conferences, courses and presentations (slides with voice over) on transplantation, given by local and international experts. Its mission is to keep you up-to-date with the most recent developments on transplantation.
Presentation
"Rapamune (Sirolimus): A New Option in Kidney Transplantation" Dr. Donald E. Hricik (biography) English - 2003-06-12 - 55 minutes
(60 slides)
Summary : This talk will focus on the de novo uses of Sirolimus in kidney transplantation. Sirolimus (SRL) inhibits TOR to antagonize the cell cycle, whereas calcineurin inhibitors (CIs) block the transcription of IL-2. These 2 mechanisms synergize with each other and because of this have certain advantages and disadvantages when used in combination. For example, when used together, SRL and CIs have lower acute rejection rates, but on the downside enhance nephrotoxicity. SRL on its own is non-nephrotoxic, may be a CI and steroid sparing drug, is effective in high-risk patients, and may be antiatherogenic and antineoplastic. On the downside SRL does cause hyperlipidemia, bone marrow suppression and impaired wound healing. This talk will cover the latest clinical data supporting these conclusions.
Learning objectives : The participant will review a wealth of recent clinical data leading to the following conclusions:
- Sirolimus is potent and synergistic with calcineurin inhibitors.
- Preliminary evidence suggests that sirolimus may facilitate CI or steroid sparing.
- Sirolimus may reduce the frequency of certain malignancies owing to its inherent antineoplastic properties.
- Sirolimus-induced hyperlipidemia must be weighed against the drug’s antiatherogenic effects.
- Further studies are warranted to determine optimal strategies to minimize wound healing problems.
