S. M. JI ET AL.
12
other hand, as shown from some conversion treatment
results, it has a suppressive effect on primary tumors as
well as on metastasis theoretically.
4.2. Safety of SRL Conversion
The main adverse reactions noted from SRL conversion
were hyperlipidemia, proteinuria, leucopenia, anemia
and pulmonary infection in severe cases. These manifes-
tations occurred mostly with the standard dose admini-
stration and blood trough levels (10 - 15 ug/L) recom-
mended by foreign experts, and as we know that the ad-
verse reactions are associated with its doses and concen-
tration given, by lowering SRL doses and concentration
should be able to reduce or prevent from these adverse
reactions to occur; therefore, we think that there could
possibly be differences between pharmacokinetic and
drug metabolism gene polymorphism as well as genetic
background variation in immune system between the
Western and Asian population, [15,16] i.e. similar to the
administration of cyclsporine, we must not adopt the C2
monitoring standards of European of American renal
recipients. To determine the appropriate SRL plasma-
dose concentration at variable intervals after transplanta-
tion in the Chinese population of renal transplant recipi-
ents will be the clinical research issue that requires a
solution from now on.
In conclusion, Ninety-three renal transplant recipients
were prospectively enrolled. CNIs(CsA and FK506) as
main immunosuppressant were converted to SRL im-
munosuppressant protocol.These observations support
the conversion treatment with sirolimus in renal trans-
plant recipients using the calcineurin inhibitor (CNI)
with one or more risk factors was effective and safe. At 3
years after conversion treatment, the survival rates of
patients and grafts were 90.9% and 75.8%, respectively.
The results from this clinical trial suggest the conversion
treatment with SRL and MMF may be a better option for
the renal transplant recipients using the CNI with risk
factors appeared.
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