Pulmonary toxicity of mTOR inhibitors in kidney transplantation: A single-center experience
Objective: The purpose of this report was to describe the clinical features of mammalian target of rapamycin inhibitors (mTORi) pulmonary toxicity in kidney recipients. Material and methods: We analyzed clinical, analytical, and image data of all kidney recipients who were immunosuppressed with ever...
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| Format: | Article |
| Language: | English |
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Permanyer
2021-04-01
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| Series: | Nefrología Latinoamericana |
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| Online Access: | https://www.nefrologialatinoamericana.com/frame_esp.php?id=58 |
| _version_ | 1819237724765290496 |
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| author | Patrícia Valério Rita Veríssimo Francisca Silva Alexandra Atalaia Tiago Saldanha André Weigert |
| author_facet | Patrícia Valério Rita Veríssimo Francisca Silva Alexandra Atalaia Tiago Saldanha André Weigert |
| author_sort | Patrícia Valério |
| collection | DOAJ |
| description | Objective: The purpose of this report was to describe the clinical features of mammalian target of rapamycin inhibitors (mTORi) pulmonary toxicity in kidney recipients. Material and methods: We analyzed clinical, analytical, and image data of all kidney recipients who were immunosuppressed with everolimus or sirolimus, between 2013 and 2018. Results: From a pool of 379 recipients, 12 presented evidence of mTORi-induced hypersensitivity pneumonitis. The median age at onset of pneumonitis was 62.8 years. The majority had chronic graft dysfunction, with a median serum creatinine of 1.9 mg/dL. All patients were under mTORi for at least 2 years. The most common symptoms were cough and fever. Chest computerized tomography documented ground-glass opacities and lower lobe involvement in all patients. Two required mechanical ventilation, one of which died (the only dead in this series). Conclusions: The size of this sample does not allow inferring about risk factors or prognosis predictors. However, most patients were male, with chronic graft dysfunction and exposure to mTORi for at least 2 years. MTORi-induced pneumonitis is rare but potentially fatal. It should be included in the differential diagnosis of pulmonary conditions in these patients. |
| first_indexed | 2024-12-23T13:24:53Z |
| format | Article |
| id | doaj.art-9d9c69383a8e45fd9760f482e602167b |
| institution | Directory Open Access Journal |
| issn | 2444-9032 |
| language | English |
| last_indexed | 2024-12-23T13:24:53Z |
| publishDate | 2021-04-01 |
| publisher | Permanyer |
| record_format | Article |
| series | Nefrología Latinoamericana |
| spelling | doaj.art-9d9c69383a8e45fd9760f482e602167b2022-12-21T17:45:21ZengPermanyerNefrología Latinoamericana2444-90322021-04-0118210.24875/NEFRO.21000019Pulmonary toxicity of mTOR inhibitors in kidney transplantation: A single-center experiencePatrícia Valério0Rita Veríssimo1Francisca Silva2Alexandra Atalaia3Tiago Saldanha4André Weigert5Nephrology Department, Centro Hospitalar de Setúbal, Setúbal, PortugalKidney Transplantation Unit, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisboa, PortugalNephrology Department, Centro Hospitalar do Funchal, Funchal, PortugalPharmaceutical Services, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisboa; 5Imaging Department, Centro Hospitalar de Lisboa Ocidental, Lisboa. PortugalPharmaceutical Services, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisboa; 5Imaging Department, Centro Hospitalar de Lisboa Ocidental, Lisboa. PortugalKidney Transplantation Unit, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisboa, PortugalObjective: The purpose of this report was to describe the clinical features of mammalian target of rapamycin inhibitors (mTORi) pulmonary toxicity in kidney recipients. Material and methods: We analyzed clinical, analytical, and image data of all kidney recipients who were immunosuppressed with everolimus or sirolimus, between 2013 and 2018. Results: From a pool of 379 recipients, 12 presented evidence of mTORi-induced hypersensitivity pneumonitis. The median age at onset of pneumonitis was 62.8 years. The majority had chronic graft dysfunction, with a median serum creatinine of 1.9 mg/dL. All patients were under mTORi for at least 2 years. The most common symptoms were cough and fever. Chest computerized tomography documented ground-glass opacities and lower lobe involvement in all patients. Two required mechanical ventilation, one of which died (the only dead in this series). Conclusions: The size of this sample does not allow inferring about risk factors or prognosis predictors. However, most patients were male, with chronic graft dysfunction and exposure to mTORi for at least 2 years. MTORi-induced pneumonitis is rare but potentially fatal. It should be included in the differential diagnosis of pulmonary conditions in these patients.https://www.nefrologialatinoamericana.com/frame_esp.php?id=58Hypersensitivity pneumonitis. Mammalian target of rapamycin inhibitors. Kidney transplantation. Pulmonary toxicity. |
| spellingShingle | Patrícia Valério Rita Veríssimo Francisca Silva Alexandra Atalaia Tiago Saldanha André Weigert Pulmonary toxicity of mTOR inhibitors in kidney transplantation: A single-center experience Nefrología Latinoamericana Hypersensitivity pneumonitis. Mammalian target of rapamycin inhibitors. Kidney transplantation. Pulmonary toxicity. |
| title | Pulmonary toxicity of mTOR inhibitors in kidney transplantation: A single-center experience |
| title_full | Pulmonary toxicity of mTOR inhibitors in kidney transplantation: A single-center experience |
| title_fullStr | Pulmonary toxicity of mTOR inhibitors in kidney transplantation: A single-center experience |
| title_full_unstemmed | Pulmonary toxicity of mTOR inhibitors in kidney transplantation: A single-center experience |
| title_short | Pulmonary toxicity of mTOR inhibitors in kidney transplantation: A single-center experience |
| title_sort | pulmonary toxicity of mtor inhibitors in kidney transplantation a single center experience |
| topic | Hypersensitivity pneumonitis. Mammalian target of rapamycin inhibitors. Kidney transplantation. Pulmonary toxicity. |
| url | https://www.nefrologialatinoamericana.com/frame_esp.php?id=58 |
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