EVEROLIMUS FOR KAPOSI'S SARCOMA TREATMENT AFTER KIDNEY TRANSPLANTATION

Abstract

Materials. The forty five y.o. man with ESRD had underwent kidney transplantation from cadaveric 31 y.o. non biting heart donor 02.04.2013. He has received standard immunosupression: MP+Tc+MMF and for 4 weeks was discharged from hospital with serum creatinine 0.25 mmol/1. On the fifth post transplant month the patient discovered on the face skin multiple tumors. The tumors had moderate growth during next month. Kaposi's sarcoma had been proven by biopsy, so we stopped tacrolimus therapy in the recipient and started everolimus treatment. During next month there was no new skin lesions and the previously registered tumors had no futher growth. From that time we have seen gradual regression of skin lesions. We support everolimus blood level 4–8 ng/ml. month of the everolimus therapy proteinuria was appeared in the patient approximately 0.5– 0.7 g per day. The next month proteinuria increased till 1.8–2.4 g per day. The daily metilprednizolon dose was increased since 4 till 10 mg. The proteinuria decreased till 0.5–0.6 g per day. The kidney function during all period was stable with serum creatinine 0.22–0.26 mmol/1. Conclusion. Everolimus treatment with simultaneous calcinevrine inhibitors withdrawn offers a promising approach to the management of Kaposi's sarcoma in kidney transplant recipients without an increased risk of acute rejection.