Improvement in renal function after everolimus introduction and calcineurin inhibitor reduction in maintenance thoracic transplant recipients: the significance of baseline glomerular filtration rate

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Satish AroraLars Gullestad

Abstract

The NOCTET (NOrdic Certican Trial in HEart and lung Transplantation) trial demonstrated that everolimus improves renal function in maintenance thoracic transplant (TTx) recipients. Nevertheless, introduction of everolimus is not recommended for patients with advanced renal failure. We evaluated NOCTET data to assess everolimus introduction amongst TTx recipients with advanced renal failure. This 12-month multicenter Scandinavian study randomized 282 maintenance TTx recipients to everolimus introduction with calcineurin inhibitor (CNI) reduction or standard CNI therapy. The measured glomerular filtration rate (mGFR) was noted at baseline and after 1-year using Cr-ethylenediaminetetraacetic acid clearance. In 21 patients with a baseline mGFR of 20 to 29 ml/min/1.73 m(2), renal function improved in the everolimus group compared with the control group ((ΔmGFR 6.7 ± 9.0 vs -1.6 ± 5.1 ml/min/1.73 m(2); p = 0.03). Amongst 173 patients with moderate renal impairment (mGFR 30-59 ml/min/1.73 m(2)), renal function improvement was also greater amongst everolimus patients than in controls (ΔmGFR 5.1 ± 11.1 vs -0.5 ± 8.7 ml/min/1.73 m(2); p < 0.01). In 55 patients with mGFR 60 to 89 ml/min/1.73 m(2), mGFR did not change significantly in eith...Continue Reading

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Citations

Jun 24, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Eugene C DePasqualeHeather J Ross
Aug 20, 2014·Drugs·Francisco González-Vílchez, José Antonio Vázquez de Prada
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May 7, 2013·Transplantation Reviews·Andreas ZuckermannHans B Lehmkuhl
Oct 16, 2015·Clinical Transplantation·Dorothea LescheJohanna Sistonen
Mar 18, 2016·Therapeutic Drug Monitoring·Maria ShipkovaPierre Marquet
Mar 22, 2014·Clinical Transplantation·Tuvia Ben GalBenjamin Medalion
Apr 18, 2014·Clinical Transplantation·Sonia SchneerYael Raviv
Jul 23, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Allan R GlanvilleUNKNOWN European and Australian Investigators in Lung Transplantation
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Aug 28, 2014·Current Opinion in Organ Transplantation·Howard J Eisen
Dec 13, 2019·Clinical Transplantation·Lavanya Bellumkonda, Jignesh Patel
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Nov 21, 2017·Clinical Transplantation·Daniel ReichartMarkus Johannes Barten
Jun 20, 2018·Drugs·Steven IvulichGregory Snell
Oct 20, 2012·Current Opinion in Organ Transplantation·Maxime TouzotJacques Dantal

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