Everolimus leads to a lower risk of BKV viremia than mycophenolic acid in de novo renal transplantation patients: a single‐center experience

Abstract

These findings suggest that in comparison with MPA and Cya, an EVR and LD-CyA regimen lowers the risk of BKV viremia after kidney transplantation and favorably alters outcomes.

BK virus nephropathy in renal transplant recipients

“…BKV clearance was reported in five and significant reduction in viremia in the remaining four RTR . Everolimus with low dose Cs A was found to be associated with lower incidence of BKVN compared with Cs A and MPA combination in new RTR . A larger study of everolimus is under way at the University of California, San Francisco (http://ClinicalTrials.gov, identifier: NCT01624948).…”

“…41 Everolimus with low dose Cs A was found to be associated with lower incidence of BKVN compared with Cs A and MPA combination in new RTR. 42 A larger study of everolimus is under way at the University of California, San Francisco (ClinicalTrials.gov, identifier: NCT01624948). Another open-label, randomized, prospective study of substitution of Tac by sirolimus, in preventing BKVN in patients with BK viremia, is being carried out by Columbia University.…”

Conversion from tacrolimus‐mycophenolate mofetil to tacrolimus‐mTOR immunosuppression after kidney‐pancreas transplantation reduces the incidence of both BK and CMV viremia

“…A number of studies have shown that the use of mammalian target of rapamycin inhibitors mTOR results in reduced rates of CMV infection . Similarly, there is evidence to suggest that mTOR inhibitors may inhibit BK viral replication, whereas tacrolimus exerts the opposite effect …”

“…[5][6][7] Similarly, there is evidence to suggest that mTOR inhibitors may inhibit BK viral replication, whereas tacrolimus exerts the opposite effect. 8,9 In this retrospective single-center review, we investigate if conversion into an mTOR inhibitor and reduced-dose tacrolimus (TAC-mTOR) at 1 month post-transplantation could lower the risk of viral infections after KP transplantation compared to standard tacrolimus and mycophenolate mofetil (TAC-MMF) immunosuppression. Board approved this study.…”

Pilot conversion trial from mycophenolic acid to everolimus in ABO-incompatible kidney-transplant recipients with BK viruria and/or viremia

“…Because BKV is of particular significance in ABO‐i patients, who are at higher risk given their high immunosuppression burden , we focused on the effect of conversion to EVR regarding the BK virus. It has been shown that conversion to mTOR inhibitor‐based maintenance immunosuppression after kidney transplantation is correlated with a lower incidence of BKV viremia and that EVR leads to a lower risk of BKV viremia compared with MPA . Patients on a Tac‐MPA regimen are at higher risk of developing BKV viremia than patients receiving Tac‐EVR.…”