title: Long-term experience with everolimus in kidney transplantation in the United States.
abstract: BACKGROUND
  Limited long-term data exist on US kidney transplant patients who have received everolimus at time of transplantation.
  
  
  METHODS
  Using data from the United Network for Organ Sharing/Organ Procurement Transplant Network database, we described patient characteristics and outcomes among adult patients who received a kidney transplant between 1998 and 2007 and received everolimus maintenance immunosuppression (n = 392) at time of discharge. Outcomes included acute rejection, new-onset diabetes posttransplant, primary graft failure, and serum creatinine. We included single-organ, first-time transplants between 1998 and 2007 as a reference group.
  
  
  RESULTS
  Primary graft survival at 3 and 5 years posttransplantation was 87.2% ± 2.1% (95% confidence interval [CI]: 82.5%-90.7%) and 77.4% ± 3.0% (95% CI: 70.8%-82.7%), respectively, in the everolimus-treated group. Improved graft survival with everolimus seemed to be more pronounced in recipients of deceased donor transplants despite the fact that everolimus-treated patients quantitatively had a higher rate of acute rejection at 3 years posttransplant versus the reference group.
  
  
  CONCLUSIONS
  Although the incidence of acute rejection was slightly higher in the everolimus-treated patients, graft survival at 3 and 5 years posttransplantation favored everolimus, with the effect being particularly notable in the recipients who received deceased donor renal transplants.
authors.affiliation: Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA. dcibrik@umich.edu
authors.forename: D
authors.initials: D
authors.lastname: Cibrik
authors.forename: S
authors.initials: S
authors.lastname: Arcona
authors.forename: E
authors.initials: E
authors.lastname: Vasquez
authors.forename: G M
authors.initials: GM
authors.lastname: Baillie
authors.forename: W
authors.initials: W
authors.lastname: Irish
mesh_terms: D000328:Adult; D003401:Creatine / Q000097:blood; D000068338:Everolimus; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014481:United States
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D003401:Creatine; D020123:Sirolimus