Wound healing complications and the use of mammalian target of rapamycin inhibitors in kidney transplantation: a critical review of the literature

B Nashan*, Franco Citterio

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo

Abstract

Surgical complications, including events such as lymphocele and urological complications that affect wound healing, are reported with an incidence of 15% to 32% after kidney transplantation. The experience of the surgeon and comorbidities play an important role in determining the risk of such complications occurring. Since the introduction of the inosine 5'-monophosphate dehydrogenase inhibitors (mycophenolate mofetil) to the immunosuppressive armamentarium, replacing the antimetabolite prodrug azathioprine, reports have associated certain forms of wound healing complications (wound dehiscence, impaired healing, lymphocele, and incisional hernia) with the use of these agents. When mammalian target of rapamycin (mTOR) inhibitors (sirolimus, everolimus) became available, these findings were observed increasingly, particularly in direct comparisons with inosine 5'-monophosphate dehydrogenase inhibitors. The purpose of this article was to review the reported incidence of wound healing complications from randomized clinical trials that investigated the use of sirolimus- and everolimus-based treatment regimens in de novo kidney transplantation and the information available from the U.S. Food and Drug Administration database. The clinical trials included were primarily identified using biomedical literature database searches, with additional studies added at the authors' discretion. This review summarizes these studies to consider whether modern mTOR inhibitor-based immunosuppressive regimens exert and affect wound healing after kidney transplantation.
Lingua originaleInglese
pagine (da-a)547-561
Numero di pagine15
RivistaTransplantation
Volume94
Numero di pubblicazione6
DOI
Stato di pubblicazionePubblicato - 2012
Pubblicato esternamente

All Science Journal Classification (ASJC) codes

  • Trapianto

Keywords

  • Combination
  • Drug Therapy
  • Humans
  • Immunosuppressive Agents
  • Kidney Transplantation
  • Postoperative Complications
  • Protein Kinase Inhibitors
  • Risk Assessment
  • Risk Factors
  • Sirolimus
  • TOR Serine-Threonine Kinases
  • Treatment Outcome
  • Wound Healing

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