Review of cytomegalovirus infection findings with mammalian target of rapamycin inhibitor-based immunosuppressive therapy in de novo renal transplant recipients

Björn Nashan, Robert Gaston, Vincent Emery, Marcus D. Säemann, Nicolas J. Mueller, Lionel Couzi, Jacques Dantal, Fuad Shihab, Shamkant Mulgaonkar, Yu Seun Kim, Daniel C. Brennan

Research output: Contribution to journalReview article

Abstract

Cytomegalovirus (CMV) infection and disease are major complications in the renal transplant recipient. The occurrence of CMV is associated with acute rejection, allograft dysfunction, significant end-organ disease, and mortality. Several clinical studies have indicated that the use of certain immunosuppressive drugs can delay the reconstitution of CMV-specific cell-mediated immune responses, thereby leading to uncontrolled CMV replication. Accumulating evidence indicates, however, that the use of the mammalian target of rapamycin (mTOR) inhibitors, sirolimus, and everolimus, may decrease the incidence and severity of CMV infection in renal transplant recipients. The purpose of this article is to review CMV infection data from randomized clinical trials that investigated the use of sirolimus-and everolimus-based treatment regimens in de novo renal transplantation. The mTOR inhibitor clinical trials included were primarily identified using biomedical literature database searches, with additional studies added at the authors' discretion. This review will summarize these studies to discuss whether mTOR inhibitor-based immunosuppressive therapy can reduce the magnitude of CMV-related complications in the de novo renal transplantation setting.

Original languageEnglish (US)
Pages (from-to)1075-1085
Number of pages11
JournalTransplantation
Volume93
Issue number11
DOIs
StatePublished - Jun 15 2012
Externally publishedYes

Keywords

  • Anti-CMV mechanism of action
  • Cytomegalovirus (CMV)
  • Everolimus
  • Mammalian target of rapamycin (mTOR) inhibitors
  • Sirolimus

ASJC Scopus subject areas

  • Transplantation

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  • Cite this

    Nashan, B., Gaston, R., Emery, V., Säemann, M. D., Mueller, N. J., Couzi, L., Dantal, J., Shihab, F., Mulgaonkar, S., Seun Kim, Y., & Brennan, D. C. (2012). Review of cytomegalovirus infection findings with mammalian target of rapamycin inhibitor-based immunosuppressive therapy in de novo renal transplant recipients. Transplantation, 93(11), 1075-1085. https://doi.org/10.1097/TP.0b013e31824810e6