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Everolimus-based immunosuppression therapy for BK virus nephropathy.

Abstract：

BACKGROUND:Mammalian target of rapamycin inhibitors (mTOR-i) have been proposed as possible immunosuppressants of choice in BK virus nephropathy (BKN) because of their antiviral capacity. On this basis, in 2007, our Service proposed a conversion to everolimus (EVE)-based therapy from calcineurin inhibitors with an anti-calcineurin-free therapy protocol in those patients diagnosed of BKN. METHODS:A prospective, single-center case series study was performed. Fifteen cases of BKN were diagnosed from 2007 to the end of 2010. According to our protocol, immunosuppressant treatment was modified in 9 of these patients with suspension of mycophenolate and conversion from tacrolimus to EVE. RESULTS:The renal function achieved by our patients after the transplantation was excellent. Mean serum creatinine (sCr) achieved was 1.16 ± 0.2 mg/dL. Evolution of the renal function after BKN diagnosis and conversion to mTOR-i was positive in all the patients. sCr on diagnosis was 1.85 ± 0.22 mg/dL, sCr at the point in time of conversion to EVE was 2 ± 0.21 mg/dL, and final sCr of the follow-up was 1.6 ± 0.39 mg/dL (P = .05). BK viremia became negative in 5 of our patients and decreased more than 95% in the remaining 4. None of the patients had an acute rejection episode after the change of immunosuppressant. CONCLUSIONS:Conversion to mTOR-i-based therapy could provide an added benefit in BKN and could be an effective strategy for the decrease of the viremia and increase of graft survival in selected patients.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Polanco N,González Monte E,Folgueira MD,Morales E,Gutiérrez Martínez E,Bengoa I,Hernández A,Morales JM,Praga M,Andrés A

doi

10.1016/j.transproceed.2014.11.008

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

57-61

issue

1

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(14)01260-3

journal_volume

47

pub_type

杂志文章

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