Konsensusempfehlung zum Einsatz von Sirolimus in der Lebertransplantation

Zusammenfassung

Sirolimus ist ein m-TOR-Inhibitor ohne renale Nebenwirkungen und mit potenziell protektiven Einflüssen auf die Malignomentstehung. Der Einsatz nach Lebertransplantation kann infolge erhöhter postoperativer Komplikationen in zwei De-novo-Therapiestudien und den Warnhinweisen der Fachinformation nicht ungezielt erfolgen. Die Teilnehmer der Konsensuskonferenz zum Einsatz von Sirolimus in der Lebertransplantation hatten als Vorgabe die Literatur zu analysieren, zu werten und den möglichen Einsatzbereich für Sirolimus im Rahmen der Lebertransplantation zu definieren. Diese Empfehlungen basieren auf einer schriftlichen Befragung unter Kenntnisstand der aktuell publizierten bzw. auf internationalen Fachkongressen vorgestellten wissenschaftlichen Daten. Die Beurteilung erfolgte analog den Kriterien zur Erstellung von Leitlinien und erlaubt eine evidenzbasierte Aussage des gegenwärtigen Wissens zum differenzierten Einsatz von Sirolimus in der Lebertransplantation. Der formulierte Konsensus spiegelt darüber hinaus auch die klinischen Erfahrungen der Konferenzteilnehmer mit Sirolimus wider.

Abstract

Sirolimus is an m-TOR inhibitor without renal side effects and potentially protects against the development of malignancy. Due to a higher incidence of complications in two trials and an official warning in the drug information, the use of Sirolimus in liver transplantation is limited. The participants of this consensus meeting had to analyse and evaluate the literature with respect to the potential role of Sirolimus in liver transplantation. This consensus statement follows the scheme normally employed for the presentation of guidelines including the grading of evidence (1a - 5) and the extent of recommendation (A-C). Moreover, the consensus included the experience of the authors with respect to the handling of Sirolimus after liver transplantation.

Schlüsselwörter

Sirolimus - Lebertransplantation - Konsensuskonferenz

Key words

Sirolimus - liver transplantation - consensus conference

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