Severe acute renal failure after exposure to sirolimus-tacrolimus in two living donor kidney recipients.

Abstract:

BACKGROUND:We began a clinical trial in African Americans comparing sirolimus-tacrolimus to standard immunosuppression. We report two African American male living donor kidney recipients who developed acute renal failure after exposure to sirolimus-tacrolimus. METHODS:Both patients received similar doses of sirolimus and tacrolimus to achieve target levels of 5 to 15 ng/mL and prednisone in tapering doses. Renal function and tacrolimus and sirolimus levels were systematically monitored. RESULTS:Although both kidneys functioned immediately, acute oliguric renal failure developed approximately 2 weeks after transplantation. Transplant kidney biopsy showed acute tubular necrosis in patient 2. Sirolimus-tacrolimus was then stopped in both patients. Both patients required temporary hemodialysis. Renal function returned 2 weeks later and was normal 2 months after transplantation on tacrolimus plus mycophenolate mofetil. CONCLUSION:Combination sirolimus-tacrolimus may cause nephrotoxicity in some patients by mechanisms that are presently unexplained.

journal_name

Transplantation

journal_title

Transplantation

authors

Lawsin L,Light JA

doi

10.1097/00007890-200301150-00029

subject

Has Abstract

pub_date

2003-01-15 00:00:00

pages

157-60

issue

1

eissn

0041-1337

issn

1534-6080

journal_volume

75

pub_type

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