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

TY - JOUR

T1 - Review of cytomegalovirus infection findings with mammalian target of rapamycin inhibitor-based immunosuppressive therapy in de novo renal transplant recipients.

AU - Nashan, Björn

AU - Gaston, Robert

AU - Emery, Vincent

AU - Säemann, Marcus D

AU - Mueller, Nicolas J

AU - Couzi, Lionel

AU - Dantal, Jacques

AU - Shihab, Fuad

AU - Mulgaonkar, Shamkant

AU - Yu, Seun Kim

AU - Brennan, Daniel C

PY - 2012

Y1 - 2012

N2 - 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.

AB - 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.

KW - Humans

KW - Kidney Transplantation

KW - Cytomegalovirus/drug effects

KW - Cytomegalovirus Infections/etiology/prevention & control

KW - Immunosuppressive Agents/pharmacology/therapeutic use

KW - Postoperative Complications/prevention & control

KW - Sirolimus/analogs & derivatives/pharmacology/therapeutic use

KW - Humans

KW - Kidney Transplantation

KW - Cytomegalovirus/drug effects

KW - Cytomegalovirus Infections/etiology/prevention & control

KW - Immunosuppressive Agents/pharmacology/therapeutic use

KW - Postoperative Complications/prevention & control

KW - Sirolimus/analogs & derivatives/pharmacology/therapeutic use

M3 - SCORING: Journal article

VL - 93

SP - 1075

EP - 1085

JO - TRANSPLANTATION

JF - TRANSPLANTATION

SN - 0041-1337

IS - 11

M1 - 11

ER -