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Sirolimus and mTOR Inhibitors: A Review of Side Effects and Specific Management in Solid Organ Transplantation

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Abstract

Inhibitors of mechanistic target of rapamycin (mTOR inhibitors) are used as antiproliferative immunosuppressive drugs and have many clinical applications in various drug combinations. Experience in transplantation studies has been gained regarding the side effect profile of these drugs and the potential benefits and limitations compared with other immunosuppressive agents. This article reviews the adverse effects of mTOR inhibitors in solid organ transplantation, with special attention given to mechanisms hypothesized to cause adverse events and their management strategies.

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Authors and Affiliations

  1. Clinical Pharmacology & Center of Clinical Investigation Paris-Est, Sorbonne Université, AP-HP, INSERM, Paris, France

    Lee S. Nguyen, Noel Zahr, Christian Funck-Brentano & Joe-Elie Salem

  2. Service de chirurgie cardiaque, Institut de Cardiologie, AP-HP, Pitié-Salpétrière University Hospital, ICAN, INSERM, Sorbonne Université, 47-53 Boulevard de l’Hopital, 75013, Paris, France

    Lee S. Nguyen

  3. Department of Internal Medicine, Pitié-Salpétrière University Hospital, AP-HP, Sorbonne Université, Paris, France

    Mathieu Vautier, Yves Allenbach & Olivier Benveniste

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LSN wrote the manuscript and contributed to its documentation and figures. MV contributed to the figures and the internal review of the paper. YA contributed to the internal review of the paper. NZ contributed to the internal review of the paper and to the table. OB provided critical insight into its documentation. CF-B and J-ES supervised the paper and provided critical insight in its internal review.

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Lee S. Nguyen, Mathieu Vautier, Yves Allenbach, Noel Zahr, Olivier Benveniste, Christian Funck-Brentano and Joe-Elie Salem have no conflicts of interest that are directly relevant to the content of this study.

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Nguyen, L.S., Vautier, M., Allenbach, Y. et al. Sirolimus and mTOR Inhibitors: A Review of Side Effects and Specific Management in Solid Organ Transplantation. Drug Saf 42, 813–825 (2019). https://doi.org/10.1007/s40264-019-00810-9

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