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Kidney Week

Abstract: PO2457

Effects of Early Conversion to mTOR Inhibitors on Viral Infections in Renal Transplant Recipients: Eight-Year Single-Center Experience

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Hassan, Waleed, The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
  • Mostafa, Hisham, Minia Nephrology and Urology University Hospital, Minia, Egypt
Background

Mammalian target of rapamycin inhibitors (mTORis) may decrease cytomegalovirus (CMV) and BK infection in renal transplant recipient. long-term effect on rejection rate deserves follow up.

Methods

This is a retrospective analysis of all patients who underwent living unrelated donor kidney transplant at Nasr city Insurance and Nile Badrawy Hospitals from 2011 to 2018, panel reactive antibody zero and no donor specific antibody. Uni- and multi-variate analysis were done to compare between mTORis based regimen and cyclosporin inhibitors (CNI)-based regimen.

Results

We identified 1458 patients who underwent living unrelated kidney transplant with intermediate risk for CMV. All patients received Induction with anti-thymocyte globulin then were maintained on mycophenolate mofetil (MMF)-CNI-prednisone for at least 6 months. They were classified into two groups: *Group I: 658 patients on mTORis (sirolimus or everolimus), who were shifted from CNI to mTOR-I due to different causes. Group II: 800 patients on CNI (cyclosporin or tacrolimus). The overall incidence of CMV infection and BK infection (Table 1) were statistically significant lower in mTORis group compared to CNI group with no statistical differences in incidence of rejections in the first 36 month but late higher rate of BPAR (Table 2).

Conclusion

mTORis/MMF is associated with low incidence of CMV and BK infection with no significant difference in rejection rate in the first 36 months. However, further regiment modification is required to reduce late rejections.