mTOR inhibitors in pediatric liver transplant recipients.

Détails

ID Serval
serval:BIB_7FFF4EA07C6F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
mTOR inhibitors in pediatric liver transplant recipients.
Périodique
Clinics and research in hepatology and gastroenterology
Auteur(s)
Dumortier J., Couchonnal E., Lacaille F., Rivet C., Debray D., Boillot O., Lachaux A., Ackermann O., Gonzales E., Wildhaber B.E., Jacquemin E., McLin V.
ISSN
2210-741X (Electronic)
ISSN-L
2210-7401
Statut éditorial
Publié
Date de publication
08/2019
Peer-reviewed
Oui
Volume
43
Numéro
4
Pages
403-409
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
During the past decade, mTOR inhibitors (mTORi), everolimus and sirolimus, have been increasingly used after adult liver transplantation (LT). The aim of the present study was to describe the use of mTORi in pediatric LT recipients.
All pediatric LT recipients who received mTORi before December 2017 from 4 European pediatric LT centers were included and analyzed.
The present retrospective study included 30 patients; 21 were male (70%), median age was 9.3 years (range: 1.2-17.1 years) at mTORi introduction. Main indications for mTORi introduction were pre-existing liver malignancy (43.3%), calcineurin inhibitor (CNI) nephrotoxicity (26.7%), or rejection (23.4%). At last follow-up, mTORi CNIs were withdrawn in 10 patients (10/29, 34.5%). The median dose of mTORi was 1.8 mg/day (range: 0.3-5.0) or 0.058 mg/kg/day (range: 0.01-0.26), and the median trough level was 5.1 μg/L (range: 1.0-15.5). After a median follow-up of 2.8 years (range: 0.2-10.0), 50.0% of the patients presented with at least one adverse event. The main adverse events included hyperlipidemia, proteinuria, dermatitis, and mucitis. Overall mTORi discontinuation rate was 23.3% (10.0% because of adverse event). Introduction of mTORi had no significant impact on renal function.
Our results suggest that mTORi can be used in pediatric LT recipients in different clinical situations, both to reinforce immunosuppressive therapy, and to reduce CNI and related toxicity.
Mots-clé
liver transplantation, mTOR inhibitor, outcome, pediatric
Pubmed
Web of science
Création de la notice
30/01/2020 16:12
Dernière modification de la notice
31/01/2020 7:26
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