No major neurologic complications with sirolimus use in heart transplant recipients

Diederik Van De Beek, Walter K Kremers, Sudhir S. Kushwaha, Christopher G A McGregor, Eelco F M Wijdicks

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

OBJECTIVE: To determine whether sirolimus therapy is associated with neurologic complications, including stroke, among heart transplant recipients. PATIENTS AND METHODS: We retrospectively studied patients who underwent heart transplant at Mayo Clinic's site in Rochester, MN, from January 1, 1988, through June 30, 2006. RESULTS: Of 313 patients in the cohort, the medical regimen in 116 patients (37%) was switched from cyclosporine-based therapy to sirolimus. The hazard ratio of sirolimus for any neurologic or psychiatric event was 1.94 (95% confidence interval, 0.67-4.29). This hazard ratio was driven mainly by the association between sirolimus and the development of tremor and depression. Cerebrovascular events occurred with a cumulative incidence of 14% but did not occur in any of the patients who received sirolimus therapy. There were no cases of posterior reversible encephalopathy syndrome with sirolimus use. CONCLUSION: No early or late episodes of major neurotoxicity occurred in heart transplant recipients using sirolimus immunosuppression. The absence of stroke and transient ischemic attacks in these high-risk transplant recipients treated with sirolimus is notable but needs confirmation in future studies.

Original languageEnglish (US)
Pages (from-to)330-332
Number of pages3
JournalMayo Clinic Proceedings
Volume84
Issue number4
DOIs
StatePublished - 2009

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Sirolimus
Nervous System
Stroke
Posterior Leukoencephalopathy Syndrome
Transplant Recipients
Transient Ischemic Attack
Tremor
Immunosuppression
Cyclosporine
Psychiatry
Therapeutics
Confidence Intervals
Transplants
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Van De Beek, D., Kremers, W. K., Kushwaha, S. S., McGregor, C. G. A., & Wijdicks, E. F. M. (2009). No major neurologic complications with sirolimus use in heart transplant recipients. Mayo Clinic Proceedings, 84(4), 330-332. https://doi.org/10.4065/84.4.330

No major neurologic complications with sirolimus use in heart transplant recipients. / Van De Beek, Diederik; Kremers, Walter K; Kushwaha, Sudhir S.; McGregor, Christopher G A; Wijdicks, Eelco F M.

In: Mayo Clinic Proceedings, Vol. 84, No. 4, 2009, p. 330-332.

Research output: Contribution to journalArticle

Van De Beek, D, Kremers, WK, Kushwaha, SS, McGregor, CGA & Wijdicks, EFM 2009, 'No major neurologic complications with sirolimus use in heart transplant recipients', Mayo Clinic Proceedings, vol. 84, no. 4, pp. 330-332. https://doi.org/10.4065/84.4.330
Van De Beek, Diederik ; Kremers, Walter K ; Kushwaha, Sudhir S. ; McGregor, Christopher G A ; Wijdicks, Eelco F M. / No major neurologic complications with sirolimus use in heart transplant recipients. In: Mayo Clinic Proceedings. 2009 ; Vol. 84, No. 4. pp. 330-332.
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