PMID- 31447189
OWN - NLM
STAT- MEDLINE
DCOM- 20191220
LR  - 20211204
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 51
IP  - 8
DP  - 2019 Oct
TI  - Preventive Role of mTOR Inhibitor in Post-Kidney Transplant Urothelial Carcinoma.
PG  - 2731-2734
LID - S0041-1345(19)30034-X [pii]
LID - 10.1016/j.transproceed.2019.03.059 [doi]
AB  - BACKGROUND: There is little evidence about whether mammalian target of rapamycin 
      (mTOR) inhibitor could prevent post-kidney transplant (KT) urothelial carcinoma 
      (UC) or not. The aim of this study is to analyze the role of mTOR inhibitor 
      add-on in tacrolimus-based kidney transplant recipients. METHOD: The data were 
      obtained from the Kaohsiung Chang Gung Memorial Hospital using the Chang Gung 
      Research Database and retrospectively reviewed from January 2000 to December 
      2015. Patients then were categorized into 2 groups: group FK (more than 2-year 
      tacrolimus [FK] prescription) and group FK + mTOR inhibitor (more than 2-year 
      tacrolimus plus at least 6-month continued sirolimus prescription). The primary 
      end point is post-KT UC development. The secondary end point is mTOR inhibitor 
      add-on effect on renal function deterioration episode. RESULTS: There were 140 
      patients with tacrolimus-based immunosuppressant (group FK) and 82 patients with 
      tacrolimus-based and add-on mTOR inhibitor regimen (group FK + mTOR inhibitor). 
      The follow-up duration, sex distribution, and combined mycophenolate mofetil rate 
      are similar in both groups. Younger age, lower tacrolimus trough level, lower UC 
      incidence, and longer KT-to-UC interval were observed. Short- to 
      intermediate-term results revealed noninferior graft outcome by creatinine level 
      or creatinine deterioration. CONCLUSIONS: In our preliminary result, mTOR 
      inhibitor add-on in patients with tacrolimus-based regimen revealed less post-KT 
      UC occurrence. In addition, noninferior graft outcome was also observed. In 
      Taiwan, a high UC prevalence area, mTOR inhibitor add-on strategy can be 
      considered as a preventive strategy for UC after KT.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Chang, Yin-Lun
AU  - Chang YL
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung, Taiwan.
FAU - Lee, Haw-Chyuan
AU  - Lee HC
AD  - Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung, Taiwan.
FAU - Luo, Hao-Lun
AU  - Luo HL
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung, Taiwan.
FAU - Chen, Yen-Ta
AU  - Chen YT
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung, Taiwan.
FAU - Chiang, Po-Hui
AU  - Chiang PH
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung, Taiwan.
FAU - Cheng, Yuan-Tso
AU  - Cheng YT
AD  - Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung, Taiwan. Electronic address: 
      ytsocheng@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20190822
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Immunosuppressive Agents)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - W36ZG6FT64 (Sirolimus)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adult
MH  - Carcinoma, Transitional Cell/*epidemiology/etiology/immunology
MH  - Female
MH  - Graft Rejection
MH  - Graft Survival/drug effects
MH  - Humans
MH  - Immunocompromised Host
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Incidence
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology/immunology
MH  - Retrospective Studies
MH  - Sirolimus/*therapeutic use
MH  - TOR Serine-Threonine Kinases/antagonists & inhibitors
MH  - Tacrolimus/therapeutic use
MH  - Taiwan
EDAT- 2019/08/27 06:00
MHDA- 2019/12/21 06:00
CRDT- 2019/08/27 06:00
PHST- 2019/01/03 00:00 [received]
PHST- 2019/02/27 00:00 [revised]
PHST- 2019/03/13 00:00 [accepted]
PHST- 2019/08/27 06:00 [pubmed]
PHST- 2019/12/21 06:00 [medline]
PHST- 2019/08/27 06:00 [entrez]
AID - S0041-1345(19)30034-X [pii]
AID - 10.1016/j.transproceed.2019.03.059 [doi]
PST - ppublish
SO  - Transplant Proc. 2019 Oct;51(8):2731-2734. doi: 
      10.1016/j.transproceed.2019.03.059. Epub 2019 Aug 22.