PMID- 34531361
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20211204
IS  - 2329-0358 (Electronic)
IS  - 1425-9524 (Print)
IS  - 1425-9524 (Linking)
VI  - 26
DP  - 2021 Sep 17
TI  - Immunological Results of Long-Term Use of Mammalian Target of Rapamycin (mTOR) 
      Inhibitors and Its Effects on Renal Graft Functions.
PG  - e932434
LID - 10.12659/AOT.932434 [doi]
AB  - BACKGROUND Calcineurin inhibitor drugs (CNI), which are the basis of 
      immunosuppression in kidney transplantation, contribute to renal graft loss, with 
      increased morbidity and mortality due to their potentially harmful effects on the 
      renal graft, cardiovascular system, and tumor pathology. For this reason, the 
      mammalian target of rapamycin inhibitors (mTORi) such as sirolimus (SRL) and 
      everolimus (EVE) has been preferred more frequently, as they are associated with 
      fewer complications and longer graft function. MATERIAL AND METHODS We enrolled 
      89 adult renal transplant patients (37 patients on mTORi and 52 on CNI) who had 
      similar age, sex, primary renal disease, dialysis type, post-transplant follow-up 
      period, and donor type. We analyzed and compared the data between patients using 
      mTORi for longer than 5 years and those using CNI regarding pre- and 
      post-transplant panel reactive antibody (PRA), and donor-specific antibody (DSA), 
      as well as post-transplantation and current graft functions. RESULTS Although 
      those using mTORi for more than 5 years had significantly higher mismatch rates 
      (P=0.024) than those using CNI, there was no significant change in PRA and DSA 
      levels. Transplant time was longer in mTORi users (P=0.025). The switch time to 
      mTORi in patients ranged from 0 to 19 years, but the average was 4 years. As 
      expected, actual spot urine protein/creatinine was significantly higher in those 
      using mTORi (P=0.009). Diabetes mellitus (DM) and BK virus nephropathy (BKVN) 
      rates were significantly higher due to switching the regimen from CNI to mTORi. 
      CONCLUSIONS Long-term use of mTORi does not appear to be an immunological 
      problem.
FAU - Tanrisev, Mehmet
AU  - Tanrisev M
AD  - Department of Nephrology, SBU Izmir Tepecik Training and Research Hospital, 
      Izmir, Turkey.
FAU - Ayna Kilicaslan, Tulay
AU  - Ayna Kilicaslan T
AD  - Department of Medical Biology and Tissue Typing Laboratory, SBU Izmir Tepecik 
      Training and Research Hospital, Medical Faculty, Izmir Katip Celebi University, 
      Izmir, Turkey.
FAU - Colak, Hulya
AU  - Colak H
AD  - Department of Nephrology, SBU Izmir Tepecik Training and Research Hospital, 
      Izmir, Turkey.
FAU - Ersan, Sibel
AU  - Ersan S
AD  - Department of Nephrology, SBU Izmir Tepecik Training and Research Hospital, 
      Izmir, Turkey.
FAU - Yilmaz, Banu
AU  - Yilmaz B
AD  - Department of Nephrology, SBU Izmir Tepecik Training and Research Hospital, 
      Izmir, Turkey.
FAU - Alp, Alper
AU  - Alp A
AD  - Department of Nephrology, Medical Faculty, Mugla Sitki Kocman University, Mugla, 
      Turkey.
FAU - Tugmen, Cem
AU  - Tugmen C
AD  - Department of General Surgery, SBU Izmir Tepecik Training and Research Hospital, 
      Izmir, Turkey.
FAU - Sevgili, Bahar Engin
AU  - Sevgili BE
AUID- ORCID: 0000-0001-5755-0132
AD  - Department of Internal Medicine, SBU Izmir Tepecik Training and Research 
      Hospital, Izmir, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20210917
PL  - United States
TA  - Ann Transplant
JT  - Annals of transplantation
JID - 9802544
RN  - 0 (Calcineurin Inhibitors)
RN  - 0 (Immunosuppressive Agents)
RN  - 9HW64Q8G6G (Everolimus)
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  - Calcineurin Inhibitors/adverse effects
MH  - Everolimus
MH  - Female
MH  - Graft Rejection/prevention & control
MH  - Humans
MH  - *Immunosuppressive Agents/adverse effects/therapeutic use
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Sirolimus
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
PMC - PMC8454254
COIS- Conflict of Interest None declare.
EDAT- 2021/09/18 06:00
MHDA- 2021/10/29 06:00
PMCR- 2021/09/17
CRDT- 2021/09/17 06:17
PHST- 2021/09/17 06:17 [entrez]
PHST- 2021/09/18 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2021/09/17 00:00 [pmc-release]
AID - 932434 [pii]
AID - 10.12659/AOT.932434 [doi]
PST - epublish
SO  - Ann Transplant. 2021 Sep 17;26:e932434. doi: 10.12659/AOT.932434.