Long-Term Experience With Everolimus in Kidney Transplantation in the United States

• Published in: Transplantation proceedings 2011-09, Vol.43 (7), p.2562-2567
• Main Authors: Cibrik, D, Arcona, S, Vasquez, E, Baillie, G.M, Irish, W
• Format: Article
• Language: English
• Subjects: Adult; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Creatine - blood; Everolimus; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Survival; Humans; Immunosuppressive Agents - therapeutic use; Kidney Transplantation; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Sirolimus - analogs & derivatives; Sirolimus - therapeutic use; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue, organ and graft immunology; United States
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.05.052

Abstract Background Limited long-term data exist on US kidney transplant patients who have received everolimus at time of transplantation. Methods Using data from the United Network for Organ Sharing/Organ Procurement Transplant Network database, we described patient characteristics and outcomes among adult patients who received a kidney transplant between 1998 and 2007 and received everolimus maintenance immunosuppression ( n = 392) at time of discharge. Outcomes included acute rejection, new-onset diabetes posttransplant, primary graft failure, and serum creatinine. We included single-organ, first-time transplants between 1998 and 2007 as a reference group. Results Primary graft survival at 3 and 5 years posttransplantation was 87.2% ± 2.1% (95% confidence interval [CI]: 82.5%–90.7%) and 77.4% ± 3.0% (95% CI: 70.8%–82.7%), respectively, in the everolimus-treated group. Improved graft survival with everolimus seemed to be more pronounced in recipients of deceased donor transplants despite the fact that everolimus-treated patients quantitatively had a higher rate of acute rejection at 3 years posttransplant versus the reference group. Conclusion Although the incidence of acute rejection was slightly higher in the everolimus-treated patients, graft survival at 3 and 5 years posttransplantation favored everolimus, with the effect being particularly notable in the recipients who received deceased donor renal transplants.