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Variability of the mammalian target of rapamycin inhibitors is correlated with long-term renal graft survival

Abstract: Background: Many studies demonstrate the relationship between the high intrapatient variability of calcineurin inhibitor (CNI) levels and poor long-term renal graft outcome. Our objective is to analyze the intrapatient variability observed in the mammalian target of rapamycin inhibitors (mTOR-i) blood levels, to compare the variability of sirolimus (SRL) with that of everolimus (EVL) in kidney transplant patients converted to an mTOR-i, and to analyze whether the coefficient of variation (CV) was correlated with long-term graft survival. Methods: We analyzed 279 adult renal transplant patients converted to an mTOR-i. CV was calculated using at least 3 blood trough levels between 3 and 18 months postconversion. Results: The mean and median CV of the entire group was 25.54% and 23.7%, respectively. SRL and EVL mean CV was 23.8% and 27.1% (P = .03), respectively. The group of patients into the last tertile with CV> 28.52% presented a lower death-censored graft survival (75.26% vs. 93.01%, P < .0001) with a mean follow-up of 66.5 months. Conclusion: The CV of mTOR-i is correlated with long-term renal graft survival, so it should be considered a prognostic factor. SRL has a lower CV than EVL in renal transplant patients converted to mTOR-i in the stable posttransplant phase.

 Fuente: Transplantation Proceedings, 2019, 51(2), 341-343

 Editorial: Elsevier

 Año de publicación: 2019

 Nº de páginas: 3

 Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.transproceed.2018.08.016

 ISSN: 0041-1345,1873-2623

 Url de la publicación: https://www.doi.org/10.1016/j.transproceed.2018.08.016

Autoría

VALERO, R.

SANCHEZ-FRUCTUOSO, A.

COS, M.A.

PEREZ-FLORES, I.