Evaluation of Treatment with a Combination of Everolimus and Low-Dose Cyclosporine A in De Novo Pediatric Kidney Transplantation Patients: A Systematic Review
Jun Wang, Nannan Gu, Mingming Yu, Jingtong Sha, Hang Wu, Yulong Gong, Haobo Zhu, Zheng Ge, Rugang Lu, Gemg Ma, Yunfei Guo
Department of Urology, Children's Hosptial of Nanjing Medical University, Nanjing, China (mainland)
Med Sci Rev 2016; 3:49-54
The aim of our systematic review was to determine the clinical efficacy, safety, and tolerability of everolimus and low-dose cyclosporine A (CsA) combination treatment in de novo pediatric kidney transplantation.
Our electronic literature searches of Medline, Cochrane Central Register of Controlled Trials (CENTRAL) and Embase (updated on May 1st 2015) checked all articles on everolimus and low-dose CSA treatment published in English language. Two authors independently made study selections, data extraction, and analysis.
A total of 3 case series and 3 clinical trials were included in our systematic review. The overall incidence rate of borderline changes, biopsy-proven acute rejection, interstitial fibrosis, and tubular atrophy, graft loss and death were 8.21%, 9.00%, 13.43%, 0.75%, and 0%, respectively. The incidence rate of urinary tract infection was 30.83%, but can be well-tolerated by giving proper medical treatment. Other reported severe adverse events, such as lymphocele, wound healing dysfunction, pyrexia, pneumonia, viral infections, were less than 10%.
Everolimus and low-dose CsA combination treatment is effective, safe, and well-tolerated in de novo pediatric kidney transplantation. However, an open-label randomized controlled clinical trial will provide an incentive to refine our clinical use of everolimus in children.
Keywords: Cyclosporine, Hospitals, Pediatric, Kidney Transplantation