What is Conversion Therapy?

Conversion therapy. Objective To study the efficacy and safety of conversion of calcineurin inhibitor (CNI) to sirolimus (SRL) in recipients with renal allergy after renal transplantation.

Conversion therapy

Conversion therapy. Objective To study the efficacy and safety of conversion of calcineurin inhibitor (CNI) to sirolimus (SRL) in recipients with renal allergy after renal transplantation.

Chinese name

Kidney transplant

Methods Forty-five renal transplant recipients with CNI as the main immunosuppressant after renal transplantation (the serum creatinine concentration increased by more than 20% or reached 176-308 mol / L in the past 6 months) were used to replace CNI with SRL. Conversion therapy. The time from the patient's kidney transplantation was 6 to 44 months, with an average of 13.24-months. Switching treatment regimen uses rapid reduction of CNI and discontinuation. The dose of other immunosuppressants used in combination with it remains unchanged during the conversion period. The first single oral loading dose of SRL is 4-6 mg / d, and the maintenance dose is 1-2 mg / d. . Followed up for 6 months to observe its clinical effects and adverse reactions. Results The blood concentration of SRL was maintained at 4 8g / L. Serum creatinine was (242.15 ± 73.04) mol / L before conversion treatment, and decreased to (188.32 ± 58.96) mol / L and (173.32 ± 58.96) at 3 months and 6 months after conversion treatment, respectively. 36 ± 58.08) mol / L (P <0.05). Blood urea nitrogen, hemoglobin, and serum calcium concentrations decreased significantly at 3 months after conversion treatment, and serum potassium and calcium concentrations decreased significantly at 6 months after conversion treatment (P <0.05). During the conversion treatment, all patients had no rejection, and the survival rate of human and kidney was 100%. Three patients had concurrent infections and improved after antibiotic treatment. CONCLUSION: Recipients of hypoglycemia or chronic allograft nephropathy after renal transplantation, replacing CNI with SRL is a safe and effective treatment option. [