Figure 6 Change in eGFR and FI after kidney transplantation stratified by immunosuppressive protocol and degree of mTOR signal enhancement. The mTOR signal score is defined as the sum of the score in phosphorylated mTOR and phosphorylated p70S6K, and phosphorylated 4EBP staining. Group 1: EVR+ with mTOR signal score decreased from 3 months to 3 years (n=18); group 2: EVR+ with mTOR signaling score increased from 3 months to 3 years (n=14); group 3: EVR− with mTOR signaling score decreased from 3 months to 3 years (n=8); group 4: EVR− with mTOR signaling score increased from 3 months to 3 years (n=20). (A) Decreases in eGFR from 3 months to 3 years after KTx (ΔeGFR=eGFR at 3 years–eGFR at 3 months) in the groups 1 and 2 (EVR+ with mTOR signal score decrease or increase) were significantly lower than those in groups 3 and 4 (EVR− with mTOR signal score decrease or increase) (P<0.01). (B) The progression of fibrosis (ΔFI=FI at 3 years–FI at 3 months) in group 1 (EVR+ with mTOR signal score decrease) was significantly milder than in the other 3 groups (P<0.001). mTOR – mammalian target of rapamycin; eGFR – estimated-glomerular filtration rate (ml/min/1.73 m2); FI – fibrosis index (%); KTx – kidney transplantation; EVR – everolimus.