Respiratory and renal functional evolutionary profiles after introduction of everolimus and minimizing doses of calcineurin inhibitors in lung transplant recipients, a descriptive observational study

Abstract

Introduction and background: chronic lung allograft dysfunction is a major obstacle to post-transplant survival. Its prevention and treatment are based on immunosuppressive therapy. Still, its incidence remains high at one year, representing the first cause of morbidity among transplant recipients. Aims and objectives: we aimed to find if adding everolimus to standard immunosuppressive regimen could improve lung function and reduce renal function decline in lung transplanted patients. Methods: we retrospectively study 36 lung transplant patients at the University Hospital of Bordeaux France. Patients with bronchiolitis obliterans syndrome (BOS) or renal function worsening due to immunosuppressive treatment for whom we introduced everolimus were included. Calcineurin inhibitor posologies were lowered. Results: in addition to an effective reduction in serum calcineurin inhibitor concentrations, everolimus allows lower rate of lung function decline in patients with BOS, with a ΔFEV1 of -15% 6 months before to – 4% 6 month after its introduction. Legend/caption: Variation of FEV1 (in %) between visits after introduction of everolimus at month 0 (M0). Glomerular filtration rates (GFR) were also stabilized. Conclusions: adding everolimus seems to be an effective and safe way of care for well-defined type of patients.