sirolimus（西罗莫司片）治什么？

Sirolimus (sirolimus tablets) has almost no nephrotoxicity compared with standard-dose calcineurin inhibitors, and has unique immunological advantages in inducing tolerance and can improve kidney transplant function. At present, this drug has been widely used in the treatment of kidney transplant patients. In addition, the drug has also been used in the treatment of liver transplantation.

(1) Kidney transplantation

In a multicenter clinical study, 31 patients with chronic allograft nephropathy (suggesting chronic nephrotoxicity of calcineurin inhibitors, with or without nonspecific renal interstitial fibrosis or tubular atrophy) diagnosed by transplant kidney biopsy were treated with a treatment regimen that switched from calcineurin inhibitors to sirolimus, with an average follow-up of 21.6 months. 

The results showed that 1 year after switching to sirolimus (rapamin) treatment, the patient's renal function was significantly improved [cGFR: (40.8±2.36) mL/min vs. (55.7±3.6) mL/min; P < 0.000], and no kidney transplant loss or patient death was observed during follow-up.

(2) Liver transplantation

Some transplant centers have reported switching from CNI to SRL (i.e., sirolimus) immunosuppressive regimen after clinical liver transplantation. Indications for adding SRL and reducing CNI dosage in the conversion regimen are: symptoms of renal or neurotoxicity caused by CNI and severe chronic rejection.

There is a study abroad of kidney transplant (n=17) and liver transplant patients (n=15) switching from CNI to SRL treatment, with a follow-up time of 6 months; 3 months after switching to SRL (plasma concentration 10-12 μg/L), the serum creatinine concentration of kidney transplant patients dropped from 219.9 μmol/L to 201.4 μmol/L (P<0.05); the glomerular filtration rate of liver transplant patients dropped from 0.45 after 6 months. ml/s increased to 0.55 ml/s, and all patient and graft survival rates were significantly improved.