[The use of mTOR inhibitors in kidney transplantation: who are the best patients and how should these inhibitors be used?].
The choice of immunosuppression treatment in the kidney transplant patient depends on many factors: a history of cutaneous tumor; immunological, vascular, and primary cytomegalovirus infection risks; delay in the graft resuming function; patient knowledge of the side effects of immunosuppressant treatments, etc. Starting from a case study, this article describes the indications and contraindications of mTOR inhibitor use in the long-term immunosuppression strategy in the kidney transplantation patient. It also discusses the delay after grafting when the mTOR inhibitors can be introduced, immediately or at a later time, and points out some advantages of mycophenolate or calcineurin inhibitor substitution with mTOR inhibitors.
Service de Néphrologie et Immunologie Clinique, CHU Tours, Hôpital Bretonneau, 2 Boulevard Tonnellé, Tours, France. buchler@med.univ-tours.fr
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D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D047908:Intracellular Signaling Peptides and Proteins / Q000037:antagonists & inhibitors*; D016030:Kidney Transplantation; D018579:Patient Selection; D017346:Protein Serine-Threonine Kinases / Q000037:antagonists & inhibitors*; D058570:TOR Serine-Threonine Kinases
D007166:Immunosuppressive Agents; D047908:Intracellular Signaling Peptides and Proteins; C546842:MTOR protein, human; D017346:Protein Serine-Threonine Kinases; D058570:TOR Serine-Threonine Kinases