BACKGROUND: mTOR inhibitors (mTORI) have emerged as alternative and additive immunosuppressive agents in pediatric renal transplantation (pRTx). Their immunosuppressive, anti-proliferative, and anti-neoplastic mechanisms have been described to be effective, whereas some side effects are alarming. In particular, growth and pubertal development are of concern. The aim of this study was to look for long-term side effects of mTORI therapy in pRTx. PATIENTS AND METHODS: The retrospective analysis focused on side effects, growth, and pubertal development under mTORI therapy in 31 children. Eighteen children were routinely monitored for estradiol, testosterone, LH, and FSH levels. RESULTS: The occurrence of bacterial infections, lymphoceles, myelosuppression, and the course of overall linear growth was comparable with other pediatric renal transplant cohorts. According to the clinical puberty status, all but one patient showed normal age-related development in parallel to normal serum hormone levels. Only one patient experienced cytomegaly virus infection under mTORI, no post-transplant lymphoproliferative disorders (PTLD) occurred. CONCLUSIONS: Long-term mTORI therapy is safe in pRTx. No negative impact on growth and pubertal development was observed.
BACKGROUND:mTOR inhibitors (mTORI) have emerged as alternative and additive immunosuppressive agents in pediatric renal transplantation (pRTx). Their immunosuppressive, anti-proliferative, and anti-neoplastic mechanisms have been described to be effective, whereas some side effects are alarming. In particular, growth and pubertal development are of concern. The aim of this study was to look for long-term side effects of mTORI therapy in pRTx. PATIENTS AND METHODS: The retrospective analysis focused on side effects, growth, and pubertal development under mTORI therapy in 31 children. Eighteen children were routinely monitored for estradiol, testosterone, LH, and FSH levels. RESULTS: The occurrence of bacterial infections, lymphoceles, myelosuppression, and the course of overall linear growth was comparable with other pediatric renal transplant cohorts. According to the clinical puberty status, all but one patient showed normal age-related development in parallel to normal serum hormone levels. Only one patient experienced cytomegaly virus infection under mTORI, no post-transplant lymphoproliferative disorders (PTLD) occurred. CONCLUSIONS: Long-term mTORI therapy is safe in pRTx. No negative impact on growth and pubertal development was observed.
Authors: Markus Guba; Philipp von Breitenbuch; Markus Steinbauer; Gudrun Koehl; Stefanie Flegel; Matthias Hornung; Christiane J Bruns; Carl Zuelke; Stefan Farkas; Matthias Anthuber; Karl-Walter Jauch; Edward K Geissler Journal: Nat Med Date: 2002-02 Impact factor: 53.440
Authors: Robert Ettenger; Peter-Friedrich Hoyer; Paul Grimm; Nicholas Webb; Chantal Loirat; John D Mahan; Mark Mentser; Patrick Niaudet; Gisela Offner; R Vandamme-Lombaerts; J Mark Hexham Journal: Pediatr Transplant Date: 2008-06
Authors: David N Franz; Elena Belousova; Steven Sparagana; E Martina Bebin; Michael D Frost; Rachel Kuperman; Olaf Witt; Michael H Kohrman; J Robert Flamini; Joyce Y Wu; Paolo Curatolo; Petrus J de Vries; Noah Berkowitz; Julie Niolat; Sergiusz Jóźwiak Journal: PLoS One Date: 2016-06-28 Impact factor: 3.240