PMID- 28507917
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2220-3230 (Print)
IS  - 2220-3230 (Electronic)
IS  - 2220-3230 (Linking)
VI  - 7
IP  - 2
DP  - 2017 Apr 24
TI  - Systemic meta-analysis assessing the short term applicability of early conversion 
      to mammalian target of rapamycin inhibitors in kidney transplant.
PG  - 144-151
LID - 10.5500/wjt.v7.i2.144 [doi]
AB  - AIM: To consolidate the present evidence of effectiveness in renal functioning 
      and graft survival following early introduction of mammalian target of rapamycin 
      (mTOR) inhibitors with or without calcineurin inhibitors (CNIs) in renal 
      transplant recipients. METHODS: We analysed the current literature following 
      PROSPERO approval describing the role of immunosuppressive agent, mTOR inhibitors 
      as an alternative to CNI within six months of renal transplant by searching the 
      PubMed, EMBASE, Cochrane, Crossref, and Scopus using MeSH terms. RESULTS: Six 
      articles of early withdrawal of CNI and introduction of mTOR-inhibitors within 
      six months of renal transplantation were sought. Glomerular filtration rate (GFR) 
      and serum creatinine were significantly better in mTOR inhibitor group with 
      equivalent survival at 12 mo, even though Biopsy Proven Acute rejection was 
      significantly higher in mTOR-inhibitor group. CONCLUSION: The evidence reviewed 
      in this meta-analysis suggests that early introduction mTOR-inhibitors 
      substantial CNI minimization. The mTOR inhibitors such as everolimus and 
      sirolimus, due to their complementary mechanism of action and favourable 
      nephrotoxicity profile; better glomerular filtration, lower serum creatinine with 
      equivalent survival. Having said that, due to the higher rejection rate, may 
      influence the use of these regimens to patients with moderate to high 
      immunological risk patients.
FAU - Kumar, Jayant
AU  - Kumar J
AD  - Jayant Kumar, Isabella Reccia, Tomokazu Kusano, Department of Cancer and Surgery, 
      Imperial College, London W120HS, United Kingdom.
FAU - Reccia, Isabella
AU  - Reccia I
AD  - Jayant Kumar, Isabella Reccia, Tomokazu Kusano, Department of Cancer and Surgery, 
      Imperial College, London W120HS, United Kingdom.
FAU - Kusano, Tomokazu
AU  - Kusano T
AD  - Jayant Kumar, Isabella Reccia, Tomokazu Kusano, Department of Cancer and Surgery, 
      Imperial College, London W120HS, United Kingdom.
FAU - Julie, Bridson M
AU  - Julie BM
AD  - Jayant Kumar, Isabella Reccia, Tomokazu Kusano, Department of Cancer and Surgery, 
      Imperial College, London W120HS, United Kingdom.
FAU - Sharma, Ajay
AU  - Sharma A
AD  - Jayant Kumar, Isabella Reccia, Tomokazu Kusano, Department of Cancer and Surgery, 
      Imperial College, London W120HS, United Kingdom.
FAU - Halawa, Ahmed
AU  - Halawa A
AD  - Jayant Kumar, Isabella Reccia, Tomokazu Kusano, Department of Cancer and Surgery, 
      Imperial College, London W120HS, United Kingdom.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Transplant
JT  - World journal of transplantation
JID - 101608356
PMC - PMC5409914
OTO - NOTNLM
OT  - Adverse events
OT  - Calcineurin inhibitors
OT  - Graft failure
OT  - Kidney transplantation
OT  - Mammalian target of rapamycin inhibitors
COIS- Conflict-of-interest statement: None of the contributing authors have any 
      conflict of interest, including specific financial interests or relationships and 
      affiliations relevant to the subject matter or materials discussed in the 
      manuscript.
EDAT- 2017/05/17 06:00
MHDA- 2017/05/17 06:01
PMCR- 2017/04/24
CRDT- 2017/05/17 06:00
PHST- 2016/11/22 00:00 [received]
PHST- 2017/02/06 00:00 [revised]
PHST- 2017/02/28 00:00 [accepted]
PHST- 2017/05/17 06:00 [entrez]
PHST- 2017/05/17 06:00 [pubmed]
PHST- 2017/05/17 06:01 [medline]
PHST- 2017/04/24 00:00 [pmc-release]
AID - 10.5500/wjt.v7.i2.144 [doi]
PST - ppublish
SO  - World J Transplant. 2017 Apr 24;7(2):144-151. doi: 10.5500/wjt.v7.i2.144.