title: Variances in the Use of Everolimus in Kidney Transplantation: A 2-Year Registry of Everyday Practice.
abstract: BACKGROUND
  Everolimus (EVL)-based immunosuppressive strategies may permit the reduction of calcineurin inhibitors (CNI) and their side effects, while offering a safe and efficient treatment. Our aim was to describe our experience with EVL in everyday practice and provide information for its optimal utilization.
  
  
  METHODS
  Prospective, multicenter study of 181 kidney transplant recipients treated with EVL as part of their immunosuppressive regimen, with a follow-up of 24 months. We studied demographic data, transplant characteristics, clinical information, drugs used, serum creatinine, estimated glomerular filtration rate (eGFR), rejection episodes, and adverse events.
  
  
  RESULTS
  In total, 181 renal transplant recipients were included. Of these, 30 (16.6%) received EVL de novo and 151 (83.4%) were converted; median time from transplantation to conversion was 10 (range, 1-312) months. Main reasons for conversion were prevention of interstitial fibrosis and tubular atrophy (23.9%), intolerance to immunosuppressants (11.1%), neoplasia (13.9%), nephrotoxicity (8.9%), and cytomegalovirus infections (8.3%). The eGFR values at baseline, months 12, and 24 were 46.4 ± 27.4 mL/min, 54.8 ± 22.9 mL/min, and 55.9 ± 26.5 ml/min, respectively. Two of 181 (1.1%) patients died, 5 of 181 (2.8%) lost their grafts, 12 of 181 (6.6%) had an episode of acute rejection, 13 of 181 (7.2%) had ≥1 serious event and infection, and 85 of 181 (49.9%) had ≥1 nonserious adverse event or infection. Multivariate analysis showed that increased eGFR at month 24 was associated with lower donor age, shorter time from transplant to EVL introduction, and a baseline eGFR ≥40 mL/min.
  
  
  CONCLUSIONS
  Through different strategies among centers, the inclusion of EVL improved renal function during the first 12 months.
authors.affiliation: Renal Transplant, Hospital Alta Complejidad Pte JD Perón, Formosa, Argentina; Foundation for Research and Assistance of Renal Disease (FINAER), Buenos Aires, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Cicora
authors.affiliation: Renal Transplant, Hospital Privado Córdoba, Argentina.
authors.forename: P
authors.initials: P
authors.lastname: Massari
authors.affiliation: Renal Transplant, Hospital Provincial del Centenario de Rosario, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Acosta
authors.affiliation: Crai Sur Cucaiba, La Plata, Argentina.
authors.forename: H
authors.initials: H
authors.lastname: Petrone
authors.affiliation: Instituto de Nefrología (Nephrology), Buenos Aires, Argentina.
authors.forename: R
authors.initials: R
authors.lastname: Cambariere
authors.affiliation: Renal Transplant, Hospital Italiano, Buenos Aires, Argentina.
authors.forename: N
authors.initials: N
authors.lastname: Imperiali
authors.affiliation: Renal Transplant, Hospital JC Perrando, Resistencia, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: López
authors.affiliation: Clínica de Nefrología, Urología y Enfermedades Cardiovasculares, Santa Fe, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Arriola
authors.affiliation: Foundation for Research and Assistance of Renal Disease (FINAER), Buenos Aires, Argentina. Electronic address: javierroberti@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Roberti
mesh_terms: D001118:Argentina; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus