Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience
Yıl: 2014 Cilt: 23 Sayı: 3 Sayfa Aralığı: 229 - 233 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience
Öz: AMAÇ: mTOR inhibitörleri (mTOR i) renal transplantasyonda tercih edilen immünsupresiflerdendir. Bu çalışmada, kalsinörin inhibitörleri (KNI) kesilerek mTOR inin başlandığı, 20 olgudan oluşan, böbrek nakilli hastalardan elde ettiğimiz deneyimler sunulacaktır. GEREÇ ve YÖNTEMLER: KNIdan mTOR iye geçiş protokolünde farklı yöntemler uygulanmıştır. Maligniteli hastalarda KNI birden kesilerek mTOR iye başlanırken KNI toksisitesi olan ve diğer nedenlerle dönüşüm yapılan olgularda ise KNI dozu azaltılarak mTOR i ile birlikte 3 gün verilmiştir. BULGULAR: Renal transplantlı 20 hastanın yaş ortalaması 43,5±8,8 yıl olup; 14 erkek 6 kadın hastadan oluşuyordu. Geçiş nedenleri; maligniteler ( n=3, %15), KNI toksitesi (n=16, %80) ve premalign lezyon (n=1 %5) idi. mTOR iye geçiş (14 hasta sirolimus, 6 hasta everolimus) transplantasyondan ortalama 62,6±45,7 ay sonra yapıldı. mTOR i sonrası ortalama takip süresi 50,5±29,9 aydır. Tedavi değişimi sırasında proteinüri miktarı ortalama 227,5±147,9 mgr/gün iken, mTOR i tedavisi sonrası bu değer artarak ortalama 636,5±338,2 mgr/gün oldu (p<0,001). mTOR i tedavisi ile kreatinin düzeylerinde artış olmasına rağmen artış istatistiksel olarak anlamlı değildi (p=0,126). Sirolimus tedavisi 3 hastada kesilmek zorunda kalındı. Nedenleri 2 hastada proteinüri, 1 hastada sirolimusa bağlı interstisyel pnömoni şeklindeydi. SONUÇ: KNI tedavisinden mTOR i tedavisine konversiyonda yan etkiler görülebilmektedir. Konversiyon yapılacak hasta seçiminde bazal renal fonksiyonların iyi olması ve proteinüri miktarının az olması yan etki sıklığını azaltabilir.
Anahtar Kelime: Konular:
Renal Transplantasyonda Kalsinörin İnhibitörlerinden mTOR İnhibitörlerine Geçiş: Tek Merkez Deneyimi
Öz: OBJECTIVE: Mammalian target of rapamycin (mTOR) inhibitors are among the immunosuppressive drugs used in renal transplantation. The aim of this study was to reveal our experiences in conversion from calcineurin inhibitors (CNI) to mTOR inhibitors in 20 renal transplant patients. MATERIAL and METHODS: Various protocols were used in the conversion from CNIs to mTOR inhibitors. CNIs were discontinued and mTOR inhibitors were initiated in patients with malignancy. In cases of CNI toxicity and in cases in which conversion was performed for other causes, reduced doses of CNIs were administered for three days in combination with mTOR inhibitors. RESULTS: The study included 20 renal transplant patients, of whom 14 were male and 6 were female. The mean age of the patients was 43.5±8.8 years. The reason for conversion was CNI toxicity in 16 patients (80%), malignancy in 3 patients (15%), and premalignant lesion in 1 patient (5%). Conversion to mTOR inhibitors [(sirolimus (n=14) and everolimus (n=6)] was performed at 62.6±45.7 months after transplantation. The mean follow-up period after administration of mTOR inhibitors was 50.5±29.9 months. The mean proteinuria at the time of conversion was 227.5±147.9 mgr/day and increased to 636.5±388.2 mgr/day after treatment with mTOR inhibitors (p<0.001). There was an increase in the creatinine levels after treatment with mTOR inhibitors, though it was not significant (p=0.126). Everolimus was not discontinued in any patient, but sirolimus had to be discontinued in three patients that was due to proteinuria in two patients and pneumonia in one patient. CONCLUSION: Conversion from CNIs to mTOR inhibitors may cause side-effects. When basal renal functions are good and when proteinuria is mild, conversion may result in fewer side effects.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | OĞUZ GÖK E, YILDIRIM T, MERHAMETSİZ Ö, Yayar O, GÜRSOY KARAVELİ G, HASPULAT A, ERCAN Z, AKOĞLU H, AKDAĞ S, AYLI D (2014). Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. , 229 - 233. |
| Chicago | OĞUZ GÖK Ebru,YILDIRIM Tolga,MERHAMETSİZ Özgür,Yayar Ozlem,GÜRSOY KARAVELİ Güner,HASPULAT Ayhan,ERCAN ZAFER,AKOĞLU Hadim,AKDAĞ SEYİT İBRAHİM,AYLI Deniz Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. (2014): 229 - 233. |
| MLA | OĞUZ GÖK Ebru,YILDIRIM Tolga,MERHAMETSİZ Özgür,Yayar Ozlem,GÜRSOY KARAVELİ Güner,HASPULAT Ayhan,ERCAN ZAFER,AKOĞLU Hadim,AKDAĞ SEYİT İBRAHİM,AYLI Deniz Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. , 2014, ss.229 - 233. |
| AMA | OĞUZ GÖK E,YILDIRIM T,MERHAMETSİZ Ö,Yayar O,GÜRSOY KARAVELİ G,HASPULAT A,ERCAN Z,AKOĞLU H,AKDAĞ S,AYLI D Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. . 2014; 229 - 233. |
| Vancouver | OĞUZ GÖK E,YILDIRIM T,MERHAMETSİZ Ö,Yayar O,GÜRSOY KARAVELİ G,HASPULAT A,ERCAN Z,AKOĞLU H,AKDAĞ S,AYLI D Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. . 2014; 229 - 233. |
| IEEE | OĞUZ GÖK E,YILDIRIM T,MERHAMETSİZ Ö,Yayar O,GÜRSOY KARAVELİ G,HASPULAT A,ERCAN Z,AKOĞLU H,AKDAĞ S,AYLI D "Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience." , ss.229 - 233, 2014. |
| ISNAD | OĞUZ GÖK, Ebru vd. "Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience". (2014), 229-233. |
| APA | OĞUZ GÖK E, YILDIRIM T, MERHAMETSİZ Ö, Yayar O, GÜRSOY KARAVELİ G, HASPULAT A, ERCAN Z, AKOĞLU H, AKDAĞ S, AYLI D (2014). Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 23(3), 229 - 233. |
| Chicago | OĞUZ GÖK Ebru,YILDIRIM Tolga,MERHAMETSİZ Özgür,Yayar Ozlem,GÜRSOY KARAVELİ Güner,HASPULAT Ayhan,ERCAN ZAFER,AKOĞLU Hadim,AKDAĞ SEYİT İBRAHİM,AYLI Deniz Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 23, no.3 (2014): 229 - 233. |
| MLA | OĞUZ GÖK Ebru,YILDIRIM Tolga,MERHAMETSİZ Özgür,Yayar Ozlem,GÜRSOY KARAVELİ Güner,HASPULAT Ayhan,ERCAN ZAFER,AKOĞLU Hadim,AKDAĞ SEYİT İBRAHİM,AYLI Deniz Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, vol.23, no.3, 2014, ss.229 - 233. |
| AMA | OĞUZ GÖK E,YILDIRIM T,MERHAMETSİZ Ö,Yayar O,GÜRSOY KARAVELİ G,HASPULAT A,ERCAN Z,AKOĞLU H,AKDAĞ S,AYLI D Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2014; 23(3): 229 - 233. |
| Vancouver | OĞUZ GÖK E,YILDIRIM T,MERHAMETSİZ Ö,Yayar O,GÜRSOY KARAVELİ G,HASPULAT A,ERCAN Z,AKOĞLU H,AKDAĞ S,AYLI D Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2014; 23(3): 229 - 233. |
| IEEE | OĞUZ GÖK E,YILDIRIM T,MERHAMETSİZ Ö,Yayar O,GÜRSOY KARAVELİ G,HASPULAT A,ERCAN Z,AKOĞLU H,AKDAĞ S,AYLI D "Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience." Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 23, ss.229 - 233, 2014. |
| ISNAD | OĞUZ GÖK, Ebru vd. "Conversion from Calcineurin Inhibitors to mTOR inhibitors in Renal Transplantation: A Single Centre Experience". Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 23/3 (2014), 229-233. |
