Everolimus in kidney transplant recipients at high cardiovascular risk: a narrative review

Area of Science:

• Nephrology
• Cardiology
• Immunology

Background:

• Kidney transplant recipients (KTRs) exhibit elevated cardiovascular (CV) morbidity and mortality.
• Immunosuppressive therapy side effects and traditional CV risk factors contribute to this increased risk.
• Current strategies like steroid or calcineurin inhibitor (CNI) minimization show inconclusive CV risk reduction data.

Purpose of the Study:

• To evaluate the potential cardioprotective role of mammalian target of rapamycin (mTOR) inhibitors, specifically everolimus, in KTRs.
• To assess the impact of mTOR inhibitors on CV risk following kidney transplantation.
• To provide expert recommendations for CV risk management in KTRs.

Main Methods:

• A panel of Italian transplantation experts convened to review existing literature.
• The review focused on the potential cardioprotective effects of the mTOR inhibitor everolimus.
• This narrative review summarizes expert discussions and literature assessment.

Main Results:

• Mammalian target of rapamycin (mTOR) inhibitors are central to CNI minimization strategies.
• mTOR inhibitors may mitigate CNI-associated side effects.
• The specific impact of everolimus on cardiovascular risk in KTRs requires further evaluation.

Conclusions:

• Cardiovascular risk management is crucial for KTRs.
• Everolimus, as an mTOR inhibitor, presents a potential strategy for reducing CV risk.
• Further research and clinical evaluation are necessary to confirm everolimus's cardioprotective benefits in KTRs.