26 May 2017 : Original article
Supplementary Administration of Everolimus Reduces Cardiac Systolic Function in Kidney Transplant RecipientsKazuma Tsujimura1ABCDEF*, Morihito Ota1ABE, Kiyoshi Chinen1B, Kiyomitsu Nagayama2A, Masato Oroku2B, Morikuni Nishihira2B, Yoshiki Shiohira2AE, Masami Abe3CD, Kunitoshi Iseki4CD, Hideki Ishida5F, Kazunari Tanabe5DFG
Ann Transplant 2017; 22:315-322
BACKGROUND: The effect of everolimus, one of the mammalian targets of rapamycin inhibitors, on cardiac function was evaluated in kidney transplant recipients.
MATERIAL AND METHODS: Seventy-six participants who underwent kidney transplant between March 2009 and May 2016 were retrospectively reviewed. To standardize everolimus administration, the following criteria were used: (1) the recipient did not have a donor-specific antigen before kidney transplantation; (2) the recipient did not have proteinuria and uncontrollable hyperlipidemia after kidney transplantation; and (3) acute rejection was not observed on protocol biopsy 3 months after kidney transplantation. According to these criteria, everolimus administration for maintenance immunosuppression after kidney transplantation was included. Cardiac function was compared between the treatment group (n=30) and non-treatment group (n=46).
RESULTS: The mean observation periods of the treatment and non-treatment groups were 41.3±12.6 and 43.9±19.8 months, respectively (p=0.573). The mean ejection fraction and fractional shortening of the treatment and non-treatment groups after kidney transplant were 66.5±7.9% vs. 69.6±5.5% (p=0.024) and 37.1±6.2% vs. 39.3±4.7% (p=0.045), respectively. In the treatment group, the mean ejection fraction and fractional shortening before and after kidney transplantation did not differ significantly (p=0.604 and 0.606, respectively). In the non-treatment group, the mean ejection fraction and fractional shortening before and after kidney transplantation differed significantly (p=0.004 and 0.006, respectively).
CONCLUSIONS: Supplementary administration of everolimus after kidney transplantation can reduce cardiac systolic function.
Keywords: Echocardiography, Immunosuppression, Kidney Transplantation
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