Toxicidad pulmonar asociada a sirolimus en el trasplante hepático / Pulmonary toxicity associated with sirolimus therapy in liver transplantation

El sirolimus es un potente inmunosupresor de uso reciente, en principio en el trasplante renal pero con una utilización cada vez mayor en el trasplante de otros órganos sólidos, como el hígado, el corazón, el pulmón o el páncreas. Está indicado en las terapias de rescate y para reducir los efectos tóxicos secundarios de los inhibidores de la calcineurina. Sin embargo, se ha asociado con una grave toxicidad pulmonar, aunque infrecuente, y se han descrito casos de neumonitis intersticial, bronquiolitis obliterante con neumonía organizativa y proteinosis alveolar. Exponemos el caso de un paciente con trasplante hepático que presentó neumonitis intersticial asociada al uso de sirolimus

Sirolimus is a potent immunosuppressive drug that began to be used in the last few years. This drug was initially used in renal transplantation but its use in other solid organ transplantations such as liver, heart, lung and pancreas, has been increasing. Sirolimus is indicated in rescue therapies and to reduce the secondary toxic effects of calcineurin inhibitors. However, this drug has been associated with infrequent but severe pulmonary toxicity and cases of interstitial pneumonitis, bronchiolitis obliterans with organizing pneumonia, and alveolar proteinosis have been described. We present the case of a male liver transplant recipient who developed interstitial pneumonitis associated with sirolimus use