In:
Clinical Transplantation, Wiley, Vol. 23, No. 1 ( 2009-01), p. 16-22
Abstract:
Abstract: Background: Sirolimus (SRL) can increase the risk of wound complications. In this study, we investigated the impact of steroids when added to SRL, in this side effect. Methods: One hundred and forty‐eight patients entered prospective studies comparing early (fifth day) with late (sixth month) steroid withdrawal. All patients were on SRL, added either to Tacrolimus (n = 56) or to cyclosporine (n = 97). At 15th day after transplantation, 68 patients were on steroids (On‐St group) and 80 were not (Off‐St group). Wound complications considered were as follows: dehiscence, lymphocele, wound leakage, hematoma and seromas. Risk factors under analysis were as follows: body mass index, diabetes, rejection, creatininemia, length of dialysis before transplantation, recipient age, being on steroids at 15th day, SRL levels. Results: The overall incidence of wound complications was significantly lower in Off‐St group than in On‐St group: 18.8% vs. 45.6%, respectively (p 〈 0.0004). In detail, lymphocele: 5.0% vs. 32.3% (p 〈 0.0001); dehiscence 0% vs. 10.3% (p 〈 0.009), leakage 6.2% vs. 8.8% (p = NS), seromas 1.4% vs. 7.5% (NS). At multivariate analysis, the addition of steroids to SRL increases 4.2‐fold the risk for wound complications. Conclusions: Early steroid withdrawal is effective in preventing both the incidence and the severity of wound‐healing complications because of SRL regime, even when started with a loading dose.
Type of Medium:
Online Resource
ISSN:
0902-0063
,
1399-0012
DOI:
10.1111/ctr.2009.23.issue-1
DOI:
10.1111/j.1399-0012.2008.00890.x
Language:
English
Publisher:
Wiley
Publication Date:
2009
detail.hit.zdb_id:
2739458-X
detail.hit.zdb_id:
2004801-4
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