Abstract
This improvement was maintained at both 1 and 3 years post-conversion (p< 0.001). In regards to pulmonary function, FEV1 decreased from the time of sirolimus initiation to 3 years post-conversion (p= 0.042), mean decrease 0.23 L (95% CI, 0.01-0.46). However, early conversion to sirolimus (< 6 months post-transplant) resulted in a trend towards improved FEV1 at 3 years (+0.017 L in the early conversion group versus -0.44 L in the late conversion group, p= 0.052). The sirolimus discontinuation rate for reasons other than death was 17.8%. Conclusion: Sirolimus is a viable immunosuppressant option after lung transplant, which successfully allows for the reduction or withdrawal of the CNI, resulting in sustained improvement in renal function. The antifibrotic properties of sirolimus may allow it to slow the progression of BOS, especially when initiated within the first 6 months of transplant.
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