The use of sirolimus should be restricted in liver transplantation

Omar Massoud, Russell H. Wiesner

Research output: Contribution to journalComment/debatepeer-review

31 Scopus citations


Sirolimus and mTOR inhibitors are important additions to the therapeutic armamentarium to prevent allograft rejection, but their role in liver transplantation is evolving. De novo use of Sirolimus in the early post-transplant period has undoubtedly been influenced by the high incidence of hepatic artery thrombosis and decreased patient and graft survival leading to a black box warning. The jury remains undecided on the role of conversion from CNIs to mTOR inhibitors in those developing renal insufficiency and it must be noted that a second warning was issued by the FDA because of decreased survival in those conversion studies. Finally, the anti-atherogenic, antiviral, and anti-neoplastic effects associated with Sirolimus, which might favor their use in certain liver transplant patients, need further evaluation before firm recommendations can be made.

Original languageEnglish (US)
Pages (from-to)288-290
Number of pages3
JournalJournal of hepatology
Issue number1
StatePublished - Jan 2012

ASJC Scopus subject areas

  • Hepatology


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