liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Everolimus With Reduced Calcineurin Inhibitor in Thoracic Transplant Recipients With Renal Dysfunction: A Multicenter, Randomized Trial
University of Oslo.
Rigshospital, Copenhagen.
University of Oslo.
Aarhus University Hospital.
Show others and affiliations
2010 (English)In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 89, no 7, 864-872 p.Article in journal (Refereed) Published
Abstract [en]

Background. The proliferation signal inhibitor everolimus offers the potential to reduce calcineurin inhibitor (CNI) exposure and alleviate CNI-related nephrotoxicity. Randomized trials in maintenance thoracic transplant patients are lacking. Methods. In a 12-month, open-labeled, multicenter study, maintenance thoracic transplant patients (glomerular filtration rate greater than= 20 mL/min/1.73m(2) and less than90 mL/min/1.73 m(2)) greater than1 year posttransplant were randomized to continue their current CNI-based immunosuppression or start everolimus with predefined CNI exposure reduction. Results. Two hundred eighty-two patients were randomized (140 everolimus, 142 controls; 190 heart, 92 lung transplants). From baseline to month 12, mean cyclosporine and tacrolimus trough levels in the everolimus cohort decreased by 57% and 56%, respectively. The primary endpoint, mean change in measured glomerular filtration rate from baseline to month 12, was 4.6 mL/min with everolimus and -0.5 mL/min in controls (Pless than0.0001). Everolimus-treated heart and lung transplant patients in the lowest tertile for time posttransplant exhibited mean increases of 7.8 mL/min and 4.9 mL/min, respectively. Biopsy-proven treated acute rejection occurred in six everolimus and four control heart transplant patients (P=0.54). In total, 138 everolimus patients (98.6%) and 127 control patients (89.4%) experienced one or more adverse event (P=0.002). Serious adverse events occurred in 66 everolimus patients (46.8%) and 44 controls (31.0%) (P=0.02). Conclusion. Introduction of everolimus with CNI reduction offers a significant improvement in renal function in maintenance heart and lung transplant recipients. The greatest benefit is observed in patients with a shorter time since transplantation.

Place, publisher, year, edition, pages
Williams and Wilkins , 2010. Vol. 89, no 7, 864-872 p.
Keyword [en]
Everolimus; Certican; CNI; Cyclosporine; Tacrolimus; Renal Impairment
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-58406DOI: 10.1097/TP.0b013e3181cbac2dISI: 000276807100015OAI: diva2:343224
Available from: 2010-08-12 Created: 2010-08-11 Last updated: 2010-08-12

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Jansson, Kjell
By organisation
Cardiology Faculty of Health SciencesDepartment of Cardiology
In the same journal
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 41 hits
ReferencesLink to record
Permanent link

Direct link