The utilization of sirolimus and the impact on wound‐healing complications in obese kidney transplant recipients. (7th August 2013)

• Record Type: Journal Article
• Authors: Hulbert, Amanda L.; Delahunty, April J.; Rajab, Amer; Forbes, Rachel C.; Winters, Holli A.
• Is Part Of: Clinical transplantation. Volume 27:Number 4(2013:Jul./Aug.)
• Page Start: E521
• Page End: E527
• Publication Date: 2013-08-07
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12183
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12183-abs-0001"> <title>Abstract</title> <sec id="ctr12183-sec-0001" sec-type="section"> <title>Background</title> <p>Wound healing is a known complication associated with sirolimus therapy. Previous studies have demonstrated that obesity is a risk factor for wound‐healing complications (WHC) in patients receiving sirolimus therapy; however, the incidence has not been defined.</p> </sec> <sec id="ctr12183-sec-0002" sec-type="section"> <title>Methods</title> <p>This is a single‐center, retrospective cohort study of de novo kidney transplant recipients (KTR) transplanted with a body mass index (BMI) of ≥30 kg/m<sup>2</sup> between January 2002 and April 2011 receiving sirolimus vs. sirolimus‐free maintenance immunosuppression.</p> </sec> <sec id="ctr12183-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 317 KTR, 71 sirolimus‐free patients and 246 sirolimus patients, were eligible for inclusion. There was no difference in the primary outcome of WHC within six months of transplant (sirolimus 32.1% vs. sirolimus‐free 29.6%, p = 0.107). Sirolimus exposure was not found to influence WHC (OR 2.906, 95% CI 0.922–9.160); however, BMI Class II (OR 1.830, 95% CI 1.051–3.186) and Class III (OR 3.154, 95% CI 1.484–6.705) were significant predictors of WHC. There was no difference in WHC between the sirolimus group and sirolimus‐free group among patients in obesity Class I (27.3% vs. 15.1%, p = 0.064), Class II (36.6% vs. 34.8%, p = 0.195), or Class III (48.0% vs. 53.3%, p = 0.243).</p> </sec> <sec id="ctr12183-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In our experience, sirolimus does not increase WHC in obese KTR and can be safely used as maintenance immunosuppression immediately following transplant.</p> </sec> </abstract>