title: Wound Healing Complications in Kidney Transplant Recipients Receiving Everolimus.
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.
authors.affiliation: 1 Nephrology Division, Hospital do Rim, Universidade Federal de Sao Paulo, São Paulo, SP, Brazil. 2 Urology Division, Hospital do Rim, Universidade Federal de Sao Paulo, São Paulo, SP, Brazil.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Ueno
authors.forename: Claudia
authors.initials: C
authors.lastname: Felipe
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ferreira
authors.forename: Marina
authors.initials: M
authors.lastname: Cristelli
authors.forename: Laila
authors.initials: L
authors.lastname: Viana
authors.forename: Juliana
authors.initials: J
authors.lastname: Mansur
authors.forename: Geovana
authors.initials: G
authors.lastname: Basso
authors.forename: Pedro
authors.initials: P
authors.lastname: Hannun
authors.forename: Wilson
authors.initials: W
authors.lastname: Aguiar
authors.forename: Helio
authors.initials: H
authors.lastname: Tedesco Silva
authors.forename: Jose
authors.initials: J
authors.lastname: Medina-Pestana
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D000961:Antilymphocyte Serum / Q000009:adverse effects; D000077552:Basiliximab; D001938:Brazil; D004359:Drug Therapy, Combination; D000068338:Everolimus / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects*; D011241:Prednisone / Q000009:adverse effects; D011446:Prospective Studies; D011993:Recombinant Fusion Proteins / Q000009:adverse effects; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D000068338:Everolimus; C512542:thymoglobulin; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus