The effect of everolimus on lung function and renal status in lung transplanted patients

Introduction Everolimus is an immunosuppressive tool in lung transplantation (LTx); the most common indications are kidney dysfunction due to calcineurin inhibitors (CNIs), onset of CLAD, and malignancy. Retrospective studies showed lung functional tests stabilization or improvement in LTx recipients with CLAD. Aim We evaluated the effect of shifting immunosuppressive regimen to everolimus, associated to tapering of CNIs, in case of CLAD onset, on respiratory and renal function in LTx patients Methods We retrospectively evaluated respiratory function data and serum creatinine in 21 Turin Lung Transplantation Center patients, from 2008 to 2015, for 1 year after the shift to everolimus for CLAD, at months 1-3-6-12. Results Everolimus allowed a significant reduction of creatinine serum levels with a -43% mean reduction of CNIs dose, obtaining stability of FEV1 and FVC at all month observations. Moreover the percent variation from baseline (%Δ) of FEV1 and FVC was stable, confirming the result indipendently from the baseline. No significant difference was found between %ΔFEV1 and %ΔFVC of patients with BOS or Conclusions In our LTx CLAD cohort, in the first follow-up year after everolimus approach, we obtained a 43% saving in CNIs dosage, protection from kidney impairement and stabilization of respiratory functional status both in terms of mean and percent variation of baseline. No difference was found in RAS vs BOS.