OBM Transplantation is an international peer-reviewed Open Access journal, which covers all evidence-based scientific studies related to transplantation, including: transplantation procedures and the maintenance of transplanted tissues or organs; assimilation of grafted tissue and the reconstitution of removed organs or parts of organs; transplantation of heart, lung, kidney, liver, pancreatic islets and bone marrow, etc. Areas related to clinical and experimental transplantation are also of interest.
OBM Transplantation is committed to rapid review and publication, and we aim at serving the international transplant community with high accessibility as well as relevant and high quality content.
We welcome original clinical studies as well as basic science, reviews, short reports/rapid communications, case reports, opinions, technical notes, book reviews as well as letters to the editor.
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Use of Everolimus in Transplantation
Submission Deadline: July 15, 2021 (Open) Submit Now
Gaetano Ciancio, MD, MBA, FACS
Brandon and Kyle Simonsen Professor of Surgery and Urology, Chief Medical Officer of the Miami Transplant Institute/Jackson Memorial Hospital, Chief Academic Officer of the Miami Transplant Institute, Director of Kidney and Kidney-Pancreas Transplant Program, Director of Advanced Uro-Oncology Surgery-Jackson Memorial Hospital, Department of Surgery and Urology, Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, 33136, USA
Research Interests: Solid organ transplantation; kidney transplantation; pancreas transplantation; kidney-pancreas transplantation; transplant infections; antibody-mediated rejection
About This Topic
An overview of clinical transplantation would primarily characterize the development of new immunosuppressive agents designed to reduce the incidence and severity of acute rejection to improve short-term outcomes, but with less marked effects long-term. Recent therapeutic protocols in kidney transplantation would include increasing attempts to: reduce calcineurin inhibitors (CNI’s) dosing, thereby also reducing the short and long-term nephrotoxicity of CNI use, reduce or avoid corticosteroids and use adjunctive maintenance antiproliferative agents or TOR inhibitors.
Calcineurin inhibitors, tacrolimus (TAC) and cyclosporine microemulsion (CSA), have been mainstay immunosuppressive agents used in preventing the occurrence of biopsy-proven acute rejection (BPAR) following solid organ transplantation. However, these medications, particularly when targeting moderate-to-high trough levels over time, can cause direct and irreversible nephrotoxic effects, contributing to long-term graft loss. The mTOR inhibitor everolimus, theoretically non-nephrotoxic drug, has been shown to further reduce BPAR incidence when combined with a CNI in adult kidney transplant patients at low to moderate immunologic risk and in liver transplant recipients.
Everolimus has antiproliferative effects on smooth vascular muscle cells, perhaps decreasing arterial intimal thickening, angiogenesis, and less well-defined causes of chronic kidney allograft injury (CAI). Everolimus in combination with a CNI may also allow for concomitant lowering of CNI maintenance levels over time without increasing BPAR risk, thereby possibly reducing longer-term graft attrition due to CAI (and chronic CNI toxicity).
Finally, everolimus has also been used for the treatment of several malignancies like neuroendocrine tumor, metastatic renal cell cancer, and multiple myeloma among other tumors.
OBM transplantation will be publishing a special issue about the use of everolimus in transplantation with the goal of gathering the best articles to describe the current state of the art in the field of transplant immunosuppression.
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