Early Switch to Mammalian Target of Rapamycin Inhibitors Is a Sustainable Treatment Approach in Renal Transplant Recipients: 7-Year Results |
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| Affiliation: | 1. Department of General Surgery, Bahcesehir University Faculty of Medicine, İstanbul, Turkey;2. Department of Internal Medicine, Kargı Ahmet Hamdi Akpinar State Hospital, Çorum, Turkey;3. Department of Nephrology, Sakarya University Faculty of Medicine, Sakarya, Turkey;1. Department of Surgery, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary;2. 2nd Department of Medicine and Cardiology Centre, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary;3. 1st Department of Medicine, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary;4. Department for Medical Translation and Communication, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary;1. Department of General Surgery, Akdeniz University Hospital, Antalya, Turkey;2. Department of Anesthesia and Reanimation, Akdeniz University Hospital, Antalya, Turkey;1. Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey;2. Organ Transplantation Center, Acibadem International Hospital, Istanbul, Turkey;1. Department of Psychiatry, Istanbul Yeniyuzyil University Gaziosmanpasa Hospital, İstanbul, Gaziosmanpasa, Turkey;2. Department of Organ Transplantation, Istanbul Yeniyuzyil University Gaziosmanpasa Hospital, İstanbul, Gaziosmanpasa, Turkey;3. Department of Internal Medicine and Organ Transplantation, Istanbul Yeniyuzyil University Gaziosmanpasa Hospital, İstanbul, Gaziosmanpasa, Turkey;1. Hepatopancreaticobiliary Surgery and Liver Transplantation Unit, Department of General Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey;2. Division of Gastroenterology, Department of Internal Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey;3. Department of Preventive Oncology, Institute of Oncology, Dokuz Eylul University School of Medicine, Izmir, Turkey;1. School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey;2. Organ Transplantation Center, Acibadem International Hospital, Istanbul, Turkey;3. Pathology, Acibadem International Hospital, Istanbul, Turkey;4. Anesthesiology and Reanimation, Acibadem International Hospital, Istanbul, Turkey |
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| Abstract: | ObjectiveThe aim of this study was to investigate the safety and sustainability of mammalian target of rapamycin inhibitor (m-TORi)-based treatment protocols in renal transplant patients.MethodsWe retrospectively evaluated a total of 206 patients who were switched to low-dose calcineurin inhibitors (CNI) + m-TORi or mycophenolate mofetil (MMF) + m-TORi treatment protocols in the first 3 months of renal transplantation between January 2010 and August 2011 in our center. Demographic and laboratory features of the patients were recorded.ResultsOf the patients included in the study, 89 (43.2%) were female and 117 (56.8%) were male. The mean age was 41.9 ± 13.8 years. Panel reactive antibody was negative in 95% of the recipients. One hundred thirty-four (65%) patients received anti-thymocyte globulin induction therapy. Initially, 108 patients were treated with cyclosporine and 98 (47.6%) were treated with tacrolimus-based regimens. One hundred thirty-five patients (65.5%) were switched to low-dose CNI + m-TORi and 71 patients (34.5%) were switched to MMF + m-TORi. The mean switching time was 3 months. At the end of the study, 161 patients (78.2%) were still continuing the m-TORi treatment protocol and 45 patients (21.8%) could not continue for various reasons (11.4% proteinuria, 5.5% edema, 2.9% acute rejection, 1% acne + oral aphthae, 1% neuropathy). The biopsy-proven acute rejection rate was 4.5% (n = 9). The mean duration of sustainability of m-TORi treatment protocol was 84.15 ± 6.79 months. Mean serum creatinine of patients who were still continuing m-TORi was 1.42 ± 1.09 mg/dL.ConclusionSwitching to m-TORi in the early posttransplant period is a safe and sustainable treatment approach. |
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