Clinical outcomes after switch to mTOR inhibitors in kidney transplant recipients

Abstract Introduction: mTOR inhibitors Sirolimus and Everolimus are an alternative for inmunosuppression in renal transplant recipients. The aim of the study was to describe the experience of patients with switch to mTOR inhibitors, followed up for more than five years. Materials and methods: Patien...

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Published inRevista colombiana de nefrología (En línea) Vol. 5; no. 1; pp. 26 - 35
Main Authors Mesa-Ramírez, Liliana, Gómez-Vega, Juan C., Pino-Escobar, Jessica, Rivera, Lina M, Manzi-Tarapues, Eliana, Posada-Chávez, Juan G., Schweineberg-López, Johanna, Durán-Rebolledo, Carlos E., Villegas-Otálora, Jorge I., Serrano-Ardila, Oscar J., Caicedo-Rusca, Luis A.
Format Journal Article
LanguagePortuguese
Published Asociación Colombiana de Nefrología e Hipertensión Arterial 01.06.2018
Subjects
SOCIAL SCIENCES, INTERDISCIPLINARY
trasplante de riñon
everolimus
inmunosupresión
sirolimus
immunosuppression
renal insufficiency chronic
insuficiencia renal crónica
Kidney transplantation
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Summary:Abstract Introduction: mTOR inhibitors Sirolimus and Everolimus are an alternative for inmunosuppression in renal transplant recipients. The aim of the study was to describe the experience of patients with switch to mTOR inhibitors, followed up for more than five years. Materials and methods: Patients with renal transplantation from 1995 to 2013, who had indication of calcineurin inhibitor (CNI) withdrawl after the third month post-transplant were included. All patients underwent renal biopsy prior to conversion. No patient had a diagnosis of chronic nephtopathy, IFTA>40 % or proteinuria >350mg/24h. A descriptive analysis for all variables was devoloped. Kaplan-Meier method was used for the patient's and graft survival and graft rejection incidence. Results: From 1273 renal transplants, the switch from CNI to mTOR inhibitors was performed in 166 (13 %), 78 % (n=129) were switched to Sirolimus. 12,6 % of the patients lost graft function and 4,2 % (n=7) died. 37% had mTOR inhibitors withdrawal, and the major cause was pathologic proteinuria. The incidence of graft rejection after switching to mTOR inhibitors was 9,6 %. The one and five year graf survival was 96,6 % and 83,5 %. The patient survival at one and five years was 98 % and 97 %. Conclusions: The use of mTOR inhibitors drugs appears to be safe in the managgement of specific renal transplant recipients, with a low rejection rate and good survival.
ISSN:2500-5006
2500-5006
DOI:10.22265/acnef.5.2.290