Monoterapia inmunosupresora con inhibidores de M-TOR en trasplante hepático: estudio comparativo entre sirolimus y everolimus
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2018
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12/07/2017
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Universidad Complutense de Madrid
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Abstract
El trasplante de órganos ha sido uno de los mayores avances de la historia de la medicina, siendo Thomas Starzl el primero en realizar un trasplante hepático en humanos en 1963. El éxito del trasplante hepático y su adecuado funcionamiento a largo plazo ha sido posible gracias al uso de fármacos inmunosupresores para prevenir el rechazo. Con el paso de los años se han ido desarrollando fármacos más potentes, con una mejor prevención del rechazo y menor tasa de efectos adversos. Los mTORi, sirolimus y everolimus, se encuentran entre dichos fármacos, presentando una menor nefrotoxicidad, así como beneficio de cara a la prevención de aparición de neoplasias de novo y recidivas del hepatocarcinoma. HIPÓTESIS Los fármacos inmunosupresores pertenecientes al grupo de los mTORi como el everolimus y el sirolimus son de aparición relativamente actual y dadas sus propiedades, están más indicados en paciente con disfunción renal o aquellos con antecedentes neoplásicos o riesgo de recidiva. Nuestra hipótesis de trabajo es que los fármacos sirolimus y everolimus (mTORi), empleados en monoterapia como tratamiento inmunosupresor en el TH durante su fase de mantenimiento, son fármacos con un perfil de seguridad, tasa de rechazo y efectos adversos similares, además de favorecer la preservación de la función renal...
Organ transplantation has been one of the greatest advances in medical history, being Thomas Starzl the first to perform a liver transplant in humans in 1963. The success of liver transplantation and its long-term proper functioning has been possible by use of immunosuppressive drugs to prevent rejection. Over the years, more powerful drugs have been developed, with a better prevention of rejection and a lower rate of adverse events. The mTORi, sirolimus and everolimus, are among these drugs, presenting a lower nephrotoxicity, as well as benefit for the prevention of de novo neoplasm appearance and hepatocellular carcinoma recurrences. HYPOTHESIS The mTORi immunosuppressants everolimus and sirolimus are relatively new and, due to their properties, are more indicated in patients with renal dysfunction or those with neoplasm history or recurrence risk. Sirolimus and everolimus (mTORi) used as monotherapy immunosuppressive treatment in liver transplant during its maintenance phase, are drugs with a similar safety profile, rejection rate and adverse events, and in addition they favored renal function preservation...
Organ transplantation has been one of the greatest advances in medical history, being Thomas Starzl the first to perform a liver transplant in humans in 1963. The success of liver transplantation and its long-term proper functioning has been possible by use of immunosuppressive drugs to prevent rejection. Over the years, more powerful drugs have been developed, with a better prevention of rejection and a lower rate of adverse events. The mTORi, sirolimus and everolimus, are among these drugs, presenting a lower nephrotoxicity, as well as benefit for the prevention of de novo neoplasm appearance and hepatocellular carcinoma recurrences. HYPOTHESIS The mTORi immunosuppressants everolimus and sirolimus are relatively new and, due to their properties, are more indicated in patients with renal dysfunction or those with neoplasm history or recurrence risk. Sirolimus and everolimus (mTORi) used as monotherapy immunosuppressive treatment in liver transplant during its maintenance phase, are drugs with a similar safety profile, rejection rate and adverse events, and in addition they favored renal function preservation...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 12-07-2017