The Role of mTOR Inhibitors in Liver Transplantation: Reviewing the Evidence
Table 8
Other properties of mTOR inhibitors.
mTOR inhibitor
Effect of mTOR inhibitors on de novo tumors
EVR
Bilbao et al. Transplant Proc. 2009; 41: 2172–6 [92]
Six recipients with de novo tumors received oncological treatment/surgery and were converted to EVR-based IS. Five were disease-free at follow-up (mean months after conversion)
EVR
Fischer et al. Am J Transplant. 2012; 12: 1855–65 [50]
Neoplasms: benign, malignant and unspecified (including cysts and polyps): 4.0% versus 8.8% (EVR versus CNI, )
SRL
Jiménez-Romero et al. Hepatogastroenterology. 2011; 58: 115–21 [62]
11 of 16 recipients who developed de novo tumors and were switched from CNI/MMF to SRL monotherapy were alive at follow-up (mean follow-up 15.7 months)
SRL
Vivarelli. Transplant Proc. 2010; 42: 2579–84 [80]
3 of 4 recipients with de novo tumors and who converted to SRL-based IS were alive and tumor-free up to 33 months after conversion
mTOR inhibitor
Effect of mTOR inhibitors on neurological symptoms
EVR
Bilbao et al. Transplant Proc. 2009; 41: 2172–6 [92]
3/3 cases of neurotoxicity resolved
EVR
Masetti et al. Am J Transplant. 2010; 10: 2252–62 [89]
Minor neurological complications: EVR: 3/52 (5.8%), CsA: 5/26 (19.2%)
SRL
Forgacs et al. Transplant Proc. 2005; 37: 1912–4 [70]
7/7 recipients showed improvement or resolution of neurological symptoms
SRL
Maramattom and WijdicksNeurology. 2004; 63: 1958–9 [64]
No neurotoxicity in 52 recipients treated with SRL from 2001–04
SRL
Morard et al. Liver Transpl. 2007; 13: 658–64 [75]
Severe CNI-associated neurological symptoms improved in 6/6 recipients who converted from CNI
SRL
Vivarelli. Transplant Proc. 2010; 42: 2579–84 [80]
Complete resolution of neurological symptoms in 14/16 recipients who converted from CNI
values are included where available. CNI: calcineurin inhibitor; CsA: cyclosporine A; EVR: everolimus; HCV: hepatitis C virus; IS: immunosuppression; MMF: mycophenolate mofetil; SRL: sirolimus; TAC: tacrolimus.
