PMID- 21839260
OWN - NLM
STAT- MEDLINE
DCOM- 20120105
LR  - 20211203
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 43
IP  - 6
DP  - 2011 Jul-Aug
TI  - Conversion to everolimus in liver transplant patients with renal dysfunction.
PG  - 2307-10
LID - 10.1016/j.transproceed.2011.06.009 [doi]
AB  - Calcineurin inhibitor (CNI) immunosuppressive therapy post-liver transplantation 
      (OLT) is important to reduce graft rejection episodes. However, these drugs show 
      important side effects, particularly renal dysfunction (RDF). Changing from CNI 
      to a nonnephrotoxic drug, as mammalian target of rapamycin (mTOR) inhibitor may 
      solve the problem. Our objective was to evaluate renal function (RF) among liver 
      transplant patients initially receiving CNI, among whom the patients with RDF 
      were converted completely or partially to an mTOR inhibitor like everolimus 
      (EVE). We performed a prospective study in liver transplant patients from 2000 to 
      2009. Creatinine levels and creatinine clearances (Cockroft-Gault) expressed as 
      mean values +/- standard deviations were measured pre- and postswitch for 
      comparisons using Wilcoxon nonparametric tests. Six patients were converted fully 
      or partially to EVE. Their mean age at the moment of introducing the new therapy 
      was 52.2 +/- 13.6 years (range = 28-60). Immunosuppression time prior to switching 
      from CNI to EVE was 23.8 +/- 26.6 months (range = 6-70). Postconversion follow-up 
      was 25.8 +/- 16.5 months (range = 8-42). All patients showed improvement in RF. The 
      creatinine level improvement was significant (P = .03) namely, from a mean of 
      2.26 +/- 0.49 to 1.21 +/- 0.57 mg/dL. Glomerular filtration rate improved from a mean 
      of 40 +/- 15.13 to 72.60 +/- 17.3 mL/min/m(2) (P = .03). Conversion from CNI to EVE 
      improved creatinine concentrations and creatinine clearances with long-term 
      effects free of graft rejection.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Perez, T
AU  - Perez T
AD  - Liver and Gastroenterology Unit, Hospital San Borja-Arriaran, University of 
      Chile, Medical School, Santiago, Chile.
FAU - Segovia, R
AU  - Segovia R
FAU - Castro, L
AU  - Castro L
FAU - Roblero, J P
AU  - Roblero JP
FAU - Estela, R
AU  - Estela R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Biomarkers)
RN  - 0 (Calcineurin Inhibitors)
RN  - 0 (Immunosuppressive Agents)
RN  - 9HW64Q8G6G (Everolimus)
RN  - AYI8EX34EU (Creatinine)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Adult
MH  - Biomarkers/blood
MH  - Calcineurin Inhibitors
MH  - Chile
MH  - Creatinine/blood
MH  - Drug Substitution
MH  - Drug Therapy, Combination
MH  - Everolimus
MH  - Female
MH  - Glomerular Filtration Rate/drug effects
MH  - Graft Rejection/immunology/prevention & control
MH  - Humans
MH  - Immunosuppressive Agents/*administration & dosage/adverse effects
MH  - Kidney/*drug effects/physiopathology
MH  - Kidney Diseases/blood/*chemically induced/physiopathology
MH  - *Liver Transplantation/adverse effects/immunology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Recovery of Function
MH  - Sirolimus/administration & dosage/*analogs & derivatives
MH  - TOR Serine-Threonine Kinases/antagonists & inhibitors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2011/08/16 06:00
MHDA- 2012/01/06 06:00
CRDT- 2011/08/16 06:00
PHST- 2011/08/16 06:00 [entrez]
PHST- 2011/08/16 06:00 [pubmed]
PHST- 2012/01/06 06:00 [medline]
AID - S0041-1345(11)00817-7 [pii]
AID - 10.1016/j.transproceed.2011.06.009 [doi]
PST - ppublish
SO  - Transplant Proc. 2011 Jul-Aug;43(6):2307-10. doi: 
      10.1016/j.transproceed.2011.06.009.