Wound Healing Complications in Kidney Transplant Recipients Receiving Everolimus. Issue 4 (April 2017)

• Record Type: Journal Article
• Authors: Ueno, Priscilla; Felipe, Claudia; Ferreira, Alexandra; Cristelli, Marina; Viana, Laila; Mansur, Juliana; Basso, Geovana; Hannun, Pedro; Aguiar, Wilson; Tedesco Silva, Helio; Medina-Pestana, Jose
• Is Part Of: Transplantation. Volume 101:Issue 4(2017)
• Publication Date: 2017-04
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000001392
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Background: De novo use of mammalian target of rapamycin inhibitors after kidney transplantation is associated with a concentration-dependent incidence of wound healing adverse events (WHAE). The objective of this analysis was to compare the incidence of WHAE in patients receiving everolimus (EVR) or mycophenolate sodium (MPS). Methods: This was a predefined subanalysis of a single-center prospective randomized study in which 288 kidney transplant recipients receiving tacrolimus and prednisone were randomized for 3 different regimens: rabbit antithymocyte globulin (r-ATG)/EVR (N = 85); basiliximab (BAS)/EVR (N = 102); BAS/MPS (N = 101). Clinical WHAE were prospectively collected using a prespecified case report form in all study visits. Abdominal ultrasound was performed at 30 days posttransplant to capture subclinical abnormalities. Surgeons were blinded to randomized treatment and no specific surgical procedures were implemented. Results: A higher proportion of patients in BAS/EVR showed at least 1 clinical WHAE (22.3% vs 35.3% vs 22.0%, P = 0.03) and total clinical and subclinical WHAE (35% vs 42% vs 26%, P = 0.014) compared with BAS/MPS, respectively. A higher proportion of patients in r-ATG/EVR showed subclinical WHAE (13% vs 7% vs 4%, P = 0.025) compared with BAS/MPS, respectively. Patients receiving EVR showed a higher risk of developing clinical or subclinical WHAE (r-ATG/EVR vs BAS/MPS hazard ratio 1.30; BAS/EVR vs BAS/MPS hazard ratio 1.73, P = 0.028). Conclusions: In this cohort of de novo kidney transplant recipients receiving tacrolimus and prednisone, the use of EVR was associated with higher incidence of combined clinical and subclinical WHAE compared with MPS. Abstract : In a single-center prospective randomized study, 288 de novo kidney transplant recipients receiving everolimus, tacrolimus and prednisone show higher incidence of combined clinical and subclinical wound healing adverse events compared to mycophenolate sodium. Supplemental digital content is available in the text.