Can mTOR inhibitors reduce the risk of late kidney allograft failure

摘要: Summary The most frequent causes of late kidney allograft failure are chronic rejection, nonalloimmune injury and death, all which may depend on the characteristics donor recipient, but also be influenced by type immunosuppression. Combining calcineurin inhibitors (CNIs) corticosteroids offers potent immunosuppression, cause side effects leading to progressive graft dysfunction or an increased risk death. New immunosuppressive strategies come from availability mTOR, a downstream effector phosphatidylinositol-3 kinase that provides signal for cell proliferation phosphorylating cascade kinases. Recent trials have shown it is possible minimize dose withdraw CNIs few weeks after transplantation when they combined with mTOR their combination make avoid use corticosteroids. Moreover, inhibiting proliferation, reduce replication cytomegalovirus inside host cells, prevent transplant vasculopathy, exert anti-oncogenic activity. All these offer ray hope reducing long-term failure.