HYPERLIPIDEMIA IN RENAL-TRANSPLANT RECIPIENTS TREATED WITH SIROLIMUS (RAPAMYCIN)

Background. Sirolimus is an interesting immunosuppressive drug that do es not seem to cause nephrotoxicity, neurotoxicity, or diabetogenicity , as commonly seen in patients treated with cyclosporine or tacrolimus . In this report, we describe a possible association between sirolimus and observed hyperlipidemia. Methods. Serum levels of triglycerides a nd cholesterol were analyzed in 11 patients who participated in a pilo t study evaluating the effect of oral sirolimus or placebo combined wi th cyclosporine and corticosteroids on the occurrence of acute renal t ransplant rejection. Results, In four of nine patients given sirolimus , significantly increased serum triglyceride levels were seen, with pe ak levels occurring 2-4 months after transplantation and ranging betwe en 11.7 and 42.0 mmol/L (reference value <2.2 mmol/L), In two patients given placebo, the serum triglyceride levels remained below 5.0 mmol/ L. after reduction or discontinuation of sirolimus, the serum triglyce ride levels decreased within 1-2 months and after 1-8 months levels ha d returned to their pretransplant values. A significant increase in se rum cholesterol levels was seen in one of nine patients given sirolimu s. Conclusion. It seems that long-term treatment with sirolimus ipl co mbination with cyclosporine and corticosteroids may increase the risk of hypertriglyceridemia.