Back to Search
Start Over
Use of Everolimus-based Immunosuppression to Decrease Cytomegalovirus Infection After Kidney Transplant.
- Source :
-
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation [Exp Clin Transplant] 2016 Aug; Vol. 14 (4), pp. 361-6. Date of Electronic Publication: 2016 Apr 04. - Publication Year :
- 2016
-
Abstract
- Objectives: Cytomegalovirus infection and disease remain an issue in solid-organ transplant. Universal prophylaxis is more cost-effective than a preemptive strategy and is associated with significantly less Cytomegalovirus resistance after kidney transplant, especially in Cytomegalovirus-seropositive donors and Cytomegalovirus-seronegative recipients.<br />Materials and Methods: Registry data and meta-analyses have shown that mammalian target of rapamycin inhibitors (sirolimus- and everolimus-based immunosuppression) are associated with significantly less Cytomegalovirus events in de novo kidney transplant patients than in patients who are treated with calcineurin inhibitors plus mycophenolate-based immunosuppression.<br />Results: Recent pooled analyses of 3 randomized controlled trials in de novo kidney transplant patients, where immunosuppression was based on cyclosporine with either mycophenolate or everolimus, showed that patients who received everolimus had significantly less Cytomegalovirus events (Cytomegalovirus viremia, Cytomegalovirus infection/disease) than those who received mycophenolate, with or without cytomegalovirus as prophylaxis. An even more recent prospective randomized controlled study on de novo kidney transplant patients with no anticytomegalovirus prophylaxis demonstrated that everolimus-based immunosuppression plus low-dose tacrolimus was associated with significantly less Cytomegalovirus infection than standard-dose tacrolimus plus mycophenolate.<br />Conclusions: The potential benefits are not fully known of such a therapeutic strategy to limit the long-term indirect effects mediated by Cytomegalovirus infections.
- Subjects :
- Cytomegalovirus pathogenicity
Drug Therapy, Combination
Everolimus adverse effects
Evidence-Based Medicine
Graft Rejection enzymology
Graft Rejection immunology
Host-Pathogen Interactions
Humans
Immunocompromised Host
Immunosuppressive Agents adverse effects
Opportunistic Infections diagnosis
Opportunistic Infections immunology
Opportunistic Infections virology
Protein Kinase Inhibitors adverse effects
Risk Factors
TOR Serine-Threonine Kinases antagonists & inhibitors
TOR Serine-Threonine Kinases metabolism
Time Factors
Treatment Outcome
Virus Activation
Cytomegalovirus immunology
Everolimus therapeutic use
Graft Rejection prevention & control
Graft Survival drug effects
Immunosuppressive Agents therapeutic use
Kidney Transplantation adverse effects
Opportunistic Infections prevention & control
Protein Kinase Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2146-8427
- Volume :
- 14
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 27041365
- Full Text :
- https://doi.org/10.6002/ect.2015.0292