| Delayed wound healing with sirolimus after liver transplant. | |
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MedLine Citation:
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PMID: 12196058 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To report 3 separate cases of wound dehiscence in liver transplant recipients receiving sirolimus for immunosuppressive therapy. CASE SUMMARIES: Three patients who had received liver transplants experienced a delay in wound granulation and healing after being placed on an immunosuppressive regimen containing sirolimus and steroids. Each patient was admitted and treated for wound dehiscence, at which time sirolimus was discontinued. When other immunosuppressive agents were substituted for sirolimus, each incisional wound granulated and closed without complication. DISCUSSION: Sirolimus is an important adjunctive immunosuppressant used to prevent acute rejection episodes in patients who have undergone transplant, particularly when nephrotoxic effects from first-line calcineurin inhibitors become problematic. The unique ability of sirolimus to inhibit smooth muscle cell proliferation and intimal thickening by blocking important growth factors may subsequently become a significant feature to prevent the development of chronic rejection. Theoretically, by this same mechanism, sirolimus may play a role in forestalling wound healing and may even promote dehiscence. CONCLUSIONS: These case reports describe patients who underwent liver transplant who developed wound dehiscence possibly secondary to sirolimus therapy. Although the cases were complicated by acute rejection, wound infections, and comorbidities, wound granulation and healing began after discontinuation of sirolimus. Substitution with another immunosuppressant may be necessary for patients who experience wound dehiscence after transplant. |
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Authors:
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Jane M Guilbeau |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 36 ISSN: 1060-0280 ISO Abbreviation: Ann Pharmacother Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-08-28 Completed Date: 2003-02-05 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 1391-5 Citation Subset: IM |
Affiliation:
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Department of Pharmacy, Ochsner Clinic Foundation, 1516 Jefferson Highway, New Orleans, LA, 70121-2484, USA. jguilbeau@ochsner.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anti-Inflammatory Agents / therapeutic use Cyclosporine / adverse effects, therapeutic use Female Graft Rejection / drug therapy, immunology Humans Immunosuppressive Agents / adverse effects*, therapeutic use Liver Transplantation / adverse effects* Male Pneumonia, Pneumocystis / complications Prednisone / therapeutic use Reoperation Sirolimus / adverse effects*, therapeutic use Surgical Wound Dehiscence / chemically induced*, drug therapy, pathology Tacrolimus / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents; 0/Immunosuppressive Agents; 109581-93-3/Tacrolimus; 53-03-2/Prednisone; 53123-88-9/Sirolimus; 59865-13-3/Cyclosporine |
| Comments/Corrections | |
Comment In:
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Ann Pharmacother. 2003 Mar;37(3):453
[PMID:
12639183
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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