PMID- 24719752
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140624
LR  - 20231110
IS  - 2090-0007 (Print)
IS  - 2090-0015 (Electronic)
IS  - 2090-0007 (Linking)
VI  - 2014
DP  - 2014
TI  - The Role of mTOR Inhibitors in Liver Transplantation: Reviewing the Evidence.
PG  - 845438
LID - 10.1155/2014/845438 [doi]
LID - 845438
AB  - Despite the success of liver transplantation, long-term complications remain, 
      including de novo malignancies, metabolic syndrome, and the recurrence of 
      hepatitis C virus (HCV) and hepatocellular carcinoma (HCC). The current mainstay 
      of treatment, calcineurin inhibitors (CNIs), can also worsen posttransplant renal 
      dysfunction, neurotoxicity, and diabetes. Clearly there is a need for better 
      immunosuppressive agents that maintain similar rates of efficacy and renal 
      function whilst minimizing adverse effects. The mammalian target of rapamycin 
      (mTOR) inhibitors with a mechanism of action that is different from other 
      immunosuppressive agents has the potential to address some of these issues. In 
      this review we surveyed the literature for reports of the use of mTOR inhibitors 
      in adult liver transplantation with respect to renal function, efficacy, safety, 
      neurological symptoms, de novo tumors, and the recurrence of HCC and HCV. The 
      results of our review indicate that mTOR inhibitors are associated with efficacy 
      comparable to CNIs while having benefits on renal function in liver 
      transplantation. We also consider newer dosing schedules that may limit side 
      effects. Finally, we discuss evidence that mTOR inhibitors may have benefits in 
      the oncology setting and in relation to HCV-related allograft fibrosis, metabolic 
      syndrome, and neurotoxicity.
FAU - Klintmalm, Goran B
AU  - Klintmalm GB
AD  - Baylor Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth 
      Street, Suite 950, Dallas, TX 75246, USA.
FAU - Nashan, Bjorn
AU  - Nashan B
AD  - Department of Hepatobiliary Surgery and Visceral Transplantation, University 
      Medical Center Eppendorf, Martinistra beta e 52, 20246 Hamburg, Germany.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20140225
PL  - United States
TA  - J Transplant
JT  - Journal of transplantation
JID - 101519118
PMC - PMC3955586
EDAT- 2014/04/11 06:00
MHDA- 2014/04/11 06:01
PMCR- 2014/02/25
CRDT- 2014/04/11 06:00
PHST- 2013/05/30 00:00 [received]
PHST- 2013/09/20 00:00 [revised]
PHST- 2013/09/21 00:00 [accepted]
PHST- 2014/04/11 06:00 [entrez]
PHST- 2014/04/11 06:00 [pubmed]
PHST- 2014/04/11 06:01 [medline]
PHST- 2014/02/25 00:00 [pmc-release]
AID - 10.1155/2014/845438 [doi]
PST - ppublish
SO  - J Transplant. 2014;2014:845438. doi: 10.1155/2014/845438. Epub 2014 Feb 25.