gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

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An open prospective pilot study for the use of Rapamycin after high-risk keratoplasty

Meeting Abstract

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  • corresponding author F. Birnbaum - Eye-Hospital, Albert-Ludwigs University, Freiburg
  • T. Reinhard - Eye-Hospital, Albert-Ludwigs University, Freiburg
  • J. Sokolowska - Eye-Hospital, Heinrich-Heine University, Düsseldorf
  • K. Mayer - Eye-Hospital, Heinrich-Heine University, Düsseldorf
  • A. Reis - Eye-Hospital, Heinrich-Heine University, Düsseldorf
  • M. Oellerich - Center of Internal Medicine, Department of Clinical Chemistry, Georg-August University, Göttingen
  • R. Sundmacher - Eye-Hospital, Heinrich-Heine University, Düsseldorf

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 037

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog528.shtml

Published: September 22, 2004

© 2004 Birnbaum et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Until now cyclosporine A (CSA) and mycophenolate-mofetil (MMF) are the only available systemic immunosuppressants for patients undergoing high-risk keratoplasty. Rapamycin has shown its immunosuppressive potential in the rat keratoplasty model. After kidney transplantation Rapamycin is part of several immunosuppressive protocols. Aim of this study was to prove the efficacy and safety of Rapamycin after penetrating high-risk keratoplasty.

Methods

Ten patients undergoing high-risk keratoplasty were included in this study. Postoperative medication was Fluocortolon 1 mg/kg/d (tapered off within 3 weeks) and Prednisolonacetate eye-drops 5x/d (tapered off within 5 months). Rapamycin was administered orally once daily (blood-trough-level 4-10 ng/ml) for 6 months. Thereafter, it was tapered off within 2 weeks.

Results

Mean follow-up is 378 days. Until now two immune reactions occurred, both of them after cessation of immunosuppression. 8 patients had partly reversible side-effects as hypercholesteremia, furunculosis, exanthem, diarrhea, epistaxis, anemia or elevation of LDH. One patient was excluded from the study due to a pneumonia after pulmonary embolism.

Conclusions

Rapamycin seems to have a similar efficacy as CSA and MMF in preventing immune reactions after high-risk keratoplasty. A broad spectrum of side-effects, however, was observed.