Effectiveness and safety of chemical inhibitors against mammalian target of rapamycin (mTOR) for primary immunosuppression in recipients of kidney transplant: A systematic review and meta-analysis

Abstract

The current systematic review and meta-analysis was undertaken to assess the efficaciousness of mammalian target of rapamycin (mTOR) inhibitors in transplant subjects with regards to kidney functions and survival, with special reference to co-administration (or absence of) calcineurin inhibitors (CNIs). The analysis was done through searching and retrieving information from online scholarly databases. The collected data represented outcomes after at least twelve months following transplantation of kidney. It was observed that parameters such as glomerular filtration rate (GFR) was improved in subjects administered with mTOR inhibitors, however some studies indicated that acute rejection following biopsy was dominant in subjects administered with mTOR inhibitors. Owing to their complementary mechanisms of action as well as beneficial effects on mitigating nephrotoxicity, concomitantly with favorable outcomes on parameters such as serum creatinine and GFR leading to increased survival, this meta-analysis proposes early utilization of mTOR inhibitors and CNI minimization in subjects with kidney transplantation.

Keywords

• Kidney transplantation
• mTOR inhibitors
• Calcineurin inhibitors
• Glomerular filtration rate
• Serum creatinine
• Nephrotoxicity