Recommendations for the use of everolimus in de novo kidney transplantation: False beliefs, myths and realities
Nefrologia. 2017 May-Jun;37(3):253-266.
doi: 10.1016/j.nefro.2016.11.007.
Epub 2017 May 24.
[Article in
English,
Spanish]
Affiliations
- 1 Servicio de Nefrología, Hospital del Mar, Barcelona, España. Electronic address: julpascual@gmail.com.
- 2 Servicio de Nefrología, Hospital Clìnic, Barcelona, España.
- 3 Servicio de Nefrología, Complexo Hospitalario Universitario A Coruña, La Coruña, España.
- 4 Servicio de Nefrología, Hospital Son Espasses, Palma de Mallorca, España.
- 5 Servicio de Nefrología, Hospital Miguel Servet, Zaragoza, España.
- 6 Servicio de Nefrología, Hospital del Mar, Barcelona, España.
- 7 Servicio de Nefrología, Hospital Doctor Peset, Valencia, España.
Abstract
The immunosuppressive combination most commonly used in de novo kidney transplantation comprises a calcineurin inhibitor (CI), tacrolimus, a mycophenolic acid derivative and steroids. The evidence which underlies this practice is based in the Symphony trial with controlled follow-up of one year, in which no comparator group included the combination CI-mTOR inhibitor. Different high-quality clinical trials support the use of everolimus as a standard immunosuppressive drug associated with reduced exposure of a CI in kidney transplantation. This combination could improve health related outcomes in kidney transplantation recipients. The present recommendations constitute an attempt to summarise the scientific evidence supporting this practice, discuss false beliefs, myths and facts, and offer specific guidelines for safe use, avoiding complications.
Keywords:
Everolimus; Inhibidores de mTOR; Kidney transplant; Trasplante renal; mTOR inhibitors.
Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Calcineurin Inhibitors / adverse effects
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Calcineurin Inhibitors / therapeutic use*
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Culture
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Everolimus / adverse effects
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Everolimus / therapeutic use*
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Humans
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Immunosuppressive Agents / adverse effects
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Immunosuppressive Agents / therapeutic use*
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Kidney Transplantation*
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Practice Guidelines as Topic
Substances
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Calcineurin Inhibitors
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Immunosuppressive Agents
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Everolimus