Table 3 Possible indications and disadvantages
From: Practical considerations for the use of mTOR inhibitors
Treatment regimen | Patients who might benefit | Disadvantages |
|---|---|---|
De novo mTOR-I-based without CNI | - Low immunological risk patients | - Wound-healing problems in obese patients |
- CNI-related side effects to be anticipated (neurotoxicity, nephrotoxicity, CNI-associated hemolytic uremic syndrome) | - High incidence of side effects of mTOR-I and mycophenolate combination | |
- Patients at risk of CMV or BKV infection | - Probably induction with lymphocyte-depleting antibodies necessary | |
- Patients at risk of post-transplant malignancy | ||
De novo mTOR-I and CNI combination | - Low and intermediate immunological risk patients | - Wound-healing problems in obese patients |
- Patients who do not tolerate an adequate dose of mycophenolate | - Possible risk of new-onset diabetes | |
- Patients at risk of CMV or BKV infection | ||
- Patients at risk of post-transplant malignancy |