title: Mammalian target of rapamycin inhibitors in organ transplantation: an unkept promise.
abstract: The initial enthusiasm for the advent of a potentially nonnephrotoxic immunosuppressant has been muted by data unmasking nephrotoxicity of mammalian target of rapamycin inhibitors, including renal podocyte injury resulting in proteinuria. Adverse reactions, including anemia, thrombocytopenia, hyperlipidemia, and especially diabetogenesis, have limited its use to niche indications such as prevention or amelioration of malignancy in organ transplant. The class seems to be best used to address malignancy in organ allograft recipients and as a first-line therapy in lymphangioleiomyomatosis.
authors.affiliation: Vanderbilt Transplant Center and the Department of Internal Medicine, Nashville, TN.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Langone
authors.affiliation: Vanderbilt Transplant Center and the Department of Internal Medicine, Nashville, TN. Electronic address: Hal.helderman@vanderbilt.edu.
authors.forename: J Harold
authors.initials: JH
authors.lastname: Helderman
mesh_terms: D000740:Anemia / Q000453:epidemiology; D004791:Enzyme Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D016377:Organ Transplantation; D050199:Podocytes / Q000187:drug effects / Q000473:pathology; D011507:Proteinuria / Q000453:epidemiology*; D012307:Risk Factors; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors*; D013921:Thrombocytopenia / Q000453:epidemiology
chemical_list: D004791:Enzyme Inhibitors; D007166:Immunosuppressive Agents; D058570:TOR Serine-Threonine Kinases