Clinical Research Papers:
Conversion to mammalian target of rapamycin inhibitors in kidney transplant recipients with de novo cancers
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Chi Yuen Cheung1, Maggie Kam Man Ma2 , Wai Leung Chak1, Ka Foon Chau1 and Sydney Chi Wai Tang2
1 Department of Medicine, Renal Unit, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong SAR
2 Department of Medicine, Division of Nephrology, The University of Hong Kong, Queen Mary Hospital, Yau Ma Tei, Hong Kong SAR
Sydney Chi Wai Tang, email:
Keywords: cancer, everolimus, kidney transplant, sirolimus
Received: December 12, 2016 Accepted: January 17, 2017 Published: January 30, 2017
Objective: To investigate the impact of mammalian target of rapamycin (mTOR) inhibitor conversion together with minimization of calcineurin inhibitor on allograft outcome and patient survival in kidney transplant recipients with post-transplant cancers.
Methods: A retrospective study of all kidney transplant recipients diagnosed to have post-transplant cancers between the period 1/1/1994 and 30/6/2015. Patients were divided into 2 groups: mTOR inhibitor group and non-conversion group. Outcome included allograft function, patient survival, graft survival, acute rejection and cancer recurrence.
Results: 115 patients (56 in mTOR inhibitor group and 59 in non-conversion group) were analyzed. Median follow up was 28 months (range: 1 month – 20 years). The allograft function at 1-year remained similar between both groups. There was no significant difference in the patient survival, graft survival and rejection free survival between both groups. More patients in the non-conversion group developed recurrence of cancers than mTOR inhibitor group but statistically not significant.
Conclusions: Use of mTOR inhibitors together with calcineurin inhibitor minimization offer a reasonable option in kidney transplant recipients who developed post-transplant cancers in view of stable renal function, low rejection rate and low cancer recurrence rate.
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