PMID- 24565231
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140225
LR  - 20211021
IS  - 2047-1440 (Print)
IS  - 2047-1440 (Electronic)
IS  - 2047-1440 (Linking)
VI  - 2
IP  - Suppl 1
DP  - 2013 Nov 20
TI  - Conversion to mTOR-inhibitor-based immunosuppression: which patients and when?
PG  - S3
LID - 10.1186/2047-1440-2-S1-S3 [doi]
AB  - Mammalian target of rapamycin (mTOR) inhibitors are currently considered an 
      alternative immunosuppressive treatment that can prevent the nephrotoxicity, 
      viral infections and malignancies that are associated with calcineurin 
      inhibitor-based immunosuppressive regimens. However, the side effects of 
      mTOR-inhibitor-based regimens lead to frequent treatment discontinuations, and 
      not all patients seem to have the same benefits from conversion to mTOR 
      inhibitors. This review focuses on long-term results of trials that have assessed 
      early and late conversion to sirolimus or everolimus. The renal benefit of late 
      conversion (>/=1 year post transplantation) is limited, except in patients with 
      good renal function and without proteinuria. Early conversion to mTOR inhibitors 
      in the first 6 months, in combination with mycophenolate mofetil, could be an 
      appropriate strategy for maintenance therapy in renal transplant recipients with 
      a low immunological risk after careful screening at the time of conversion. Good 
      renal function (glomerular filtration rate >40 ml/ minute), weak proteinuria (<1 
      g/day), an absence of previous acute rejection and subclinical rejection, and 
      appearance of donor-specific anti-human leukocyte antigen antibodies appear to be 
      the most important criteria in identifying patients for whom conversion to an 
      mTOR inhibitor may improve renal function at 5 years.
FAU - Gatault, Philippe
AU  - Gatault P
FAU - Lebranchu, Yvon
AU  - Lebranchu Y
LA  - eng
PT  - Journal Article
DEP - 20131120
PL  - England
TA  - Transplant Res
JT  - Transplantation research
JID - 101597592
PMC - PMC3834549
EDAT- 2014/02/26 06:00
MHDA- 2014/02/26 06:01
PMCR- 2013/11/20
CRDT- 2014/02/26 06:00
PHST- 2014/02/26 06:00 [entrez]
PHST- 2014/02/26 06:00 [pubmed]
PHST- 2014/02/26 06:01 [medline]
PHST- 2013/11/20 00:00 [pmc-release]
AID - 2047-1440-2-S1-S3 [pii]
AID - 10.1186/2047-1440-2-S1-S3 [doi]
PST - ppublish
SO  - Transplant Res. 2013 Nov 20;2(Suppl 1):S3. doi: 10.1186/2047-1440-2-S1-S3. Epub 
      2013 Nov 20.