ImmunosuppressionPneumonitis Associated With Mammalian Target of Rapamycin Inhibitors in Renal Transplant Recipients: A Single-Center Experience
Section snippets
Patients and Methods
We reviewed the medical records at a single renal transplantation center of 186 patients receiving (Si); n = 40; (11 de novo and 29 after conversion) (Ev); n = 146; (14 de novo and 132 after conversion). The de novo cases included patients in the Spanish trials in 2000 (Si) and 2005 (Ev). The patients were switched to mTORi owing to chronic transplant nephropathy renal CNi toxicity, cancer, or prophylaxis. Seven patients underwent baseline treatment with cyclosporine, 5 with azathioprine 2 with
Results
Among 186 patients receiving mTORi, 8 (4.3%) were identified with interstitial pneumonitis, 3 with Si 5 with Ev. The patient characteristics are summarized in Table 1. Only 1 patient with de novo use of mTORi (Si) developed pneumonitis (4%) and 7/161 (4.34%) after late conversion. The 7 patients who underwent late conversion, at 7–13 years after transplantation due to renal dysfunction (n = 4), prophylaxis of CNi toxicity or tumor (n = 3) skin plus parotid cancer (n = 1). The clinical
Discussion
The frequency of interstitial pneumonitis is increased in renal transplant recipients treated with mTORi. Our study revealed 8/186 cases (4.3%) with pneumonitis, consistant with the estimated frequencies of 4%–11%.1, 2, 3 Weiner et al1 presented 11 cases summarizing the literature on pneumonitis associated with Si among > 60 cases between 2004 and 2007. Most cases have been related to Si, although more recently similar data have been published with Ev.2, 3 All of our patients underwent late
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