Clinical outcomes after switch to mTOR inhibitors in kidney transplant recipients
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| Format: | Artículo científico |
| Language: | en |
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Asociación Colombiana de Nefrología e Hipertensión Arterial
2018
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| author | Liliana Mesa-Ramírez |
| author_facet | Liliana Mesa-Ramírez |
| contents | Clinical outcomes after switch to mTOR inhibitors in kidney transplant recipients Liliana Mesa-Ramírez Juan C. Gómez-Vega Jessica Pino-Escobar Lina M Rivera Eliana Manzi-Tarapues Juan G. Posada-Chávez Johanna Schweineberg-López Carlos E. Durán-Rebolledo Jorge I. Villegas-Otálora Oscar J. Serrano-Ardila Luis A. Caicedo-Rusca Medicina sirolimus everolimus immunosuppression Kidney transplantation renal insufficiency chronic Introduction: mTOR inhibitors Sirolimus and Everolimus are an alternative for inmunosuppression in renal transplant recipients. The aim of the study was to describe the experience of patients with switch to mTOR inhibitors, followed up for more than five years.Materials and methods: Patients with renal transplantation from 1995 to 2013, who had indication of calcineurin inhibitor (CNI) withdrawl after the third month post-transplant were included. All patients underwent renal biopsy prior to conversion. No patient had a diagnosis of chronic nephtopathy, IFTA>40 % or proteinuria >350mg/24h. A descriptive analysis for all variables was devoloped. Kaplan-Meier method was used for the patient's and graft survival and graft rejection incidence.Results: From 1273 renal transplants, the switch from CNI to mTOR inhibitors was performed in 166 (13 %), 78 % (n=129) were switched to Sirolimus. 12,6 % of the patients lost graft function and 4,2 % (n=7) died. 37% had mTOR inhibitors withdrawal, and the major cause was pathologic proteinuria. The incidence of graft rejection after switching to mTOR inhibitors was 9,6 %. The one and five year graf survival was 96,6 % and 83,5 %. The patient survival at one and five years was 98 % and 97 %.Conclusions: The use of mTOR inhibitors drugs appears to be safe in the managgement of specific renal transplant recipients, with a low rejection rate and good survival. 2018 artículo científico 2389-7708 https://www.redalyc.org/articulo.oa?id=560159496003 https://www.redalyc.org/journal/5601/560159496003/ https://www.redalyc.org/journal/5601/560159496003/html/ https://www.redalyc.org/journal/5601/560159496003/560159496003.epub https://www.redalyc.org/journal/5601/560159496003/movil 10.22265/acnef.5.2.290 en http://www.redalyc.org/revista.oa?id=5601 Revista Colombiana de Nefrología application/pdf Asociación Colombiana de Nefrología e Hipertensión Arterial Revista Colombiana de Nefrología (Colombia) Num.1 Vol.5 |
| format | Artículo científico |
| id | redalyc_560159496003 |
| institution | Redalyc |
| language | en |
| publishDate | 2018 |
| publisher | Asociación Colombiana de Nefrología e Hipertensión Arterial |
| spellingShingle | Clinical outcomes after switch to mTOR inhibitors in kidney transplant recipients Liliana Mesa-Ramírez Medicina sirolimus everolimus immunosuppression Kidney transplantation renal insufficiency chronic Clinical outcomes after switch to mTOR inhibitors in kidney transplant recipients Liliana Mesa-Ramírez Juan C. Gómez-Vega Jessica Pino-Escobar Lina M Rivera Eliana Manzi-Tarapues Juan G. Posada-Chávez Johanna Schweineberg-López Carlos E. Durán-Rebolledo Jorge I. Villegas-Otálora Oscar J. Serrano-Ardila Luis A. Caicedo-Rusca Medicina sirolimus everolimus immunosuppression Kidney transplantation renal insufficiency chronic Introduction: mTOR inhibitors Sirolimus and Everolimus are an alternative for inmunosuppression in renal transplant recipients. The aim of the study was to describe the experience of patients with switch to mTOR inhibitors, followed up for more than five years.Materials and methods: Patients with renal transplantation from 1995 to 2013, who had indication of calcineurin inhibitor (CNI) withdrawl after the third month post-transplant were included. All patients underwent renal biopsy prior to conversion. No patient had a diagnosis of chronic nephtopathy, IFTA>40 % or proteinuria >350mg/24h. A descriptive analysis for all variables was devoloped. Kaplan-Meier method was used for the patient's and graft survival and graft rejection incidence.Results: From 1273 renal transplants, the switch from CNI to mTOR inhibitors was performed in 166 (13 %), 78 % (n=129) were switched to Sirolimus. 12,6 % of the patients lost graft function and 4,2 % (n=7) died. 37% had mTOR inhibitors withdrawal, and the major cause was pathologic proteinuria. The incidence of graft rejection after switching to mTOR inhibitors was 9,6 %. The one and five year graf survival was 96,6 % and 83,5 %. The patient survival at one and five years was 98 % and 97 %.Conclusions: The use of mTOR inhibitors drugs appears to be safe in the managgement of specific renal transplant recipients, with a low rejection rate and good survival. 2018 artículo científico 2389-7708 https://www.redalyc.org/articulo.oa?id=560159496003 https://www.redalyc.org/journal/5601/560159496003/ https://www.redalyc.org/journal/5601/560159496003/html/ https://www.redalyc.org/journal/5601/560159496003/560159496003.epub https://www.redalyc.org/journal/5601/560159496003/movil 10.22265/acnef.5.2.290 en http://www.redalyc.org/revista.oa?id=5601 Revista Colombiana de Nefrología application/pdf Asociación Colombiana de Nefrología e Hipertensión Arterial Revista Colombiana de Nefrología (Colombia) Num.1 Vol.5 |
| title | Clinical outcomes after switch to mTOR inhibitors in kidney transplant recipients |
| topic | Medicina sirolimus everolimus immunosuppression Kidney transplantation renal insufficiency chronic |
| url | https://www.redalyc.org/articulo.oa?id=560159496003 https://www.redalyc.org/journal/5601/560159496003/ https://www.redalyc.org/journal/5601/560159496003/html/ https://www.redalyc.org/journal/5601/560159496003/560159496003.epub https://www.redalyc.org/journal/5601/560159496003/movil |