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Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities
Mammalian target of rapamycin inhibitors (mTOR-I) lacks nephrotoxicity, has antineoplastic effects, and reduces viral infections in kidney transplant recipients. Earlier studies reported a significant incidence of wound healing complications and lymphocele. This resulted in the uncomfortable willing...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901320/ https://www.ncbi.nlm.nih.gov/pubmed/35265364 http://dx.doi.org/10.1155/2022/6255339 |
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author | Mabood Khalil, Muhammad Abdul Al-Ghamdi, Saeed M. G Dawood, Ubaidullah Shaik Ahmed Khamis, Said Sayed Ishida, Hideki Chong, Vui Heng Tan, Jackson |
author_facet | Mabood Khalil, Muhammad Abdul Al-Ghamdi, Saeed M. G Dawood, Ubaidullah Shaik Ahmed Khamis, Said Sayed Ishida, Hideki Chong, Vui Heng Tan, Jackson |
author_sort | Mabood Khalil, Muhammad Abdul |
collection | PubMed |
description | Mammalian target of rapamycin inhibitors (mTOR-I) lacks nephrotoxicity, has antineoplastic effects, and reduces viral infections in kidney transplant recipients. Earlier studies reported a significant incidence of wound healing complications and lymphocele. This resulted in the uncomfortable willingness of transplant clinicians to use these agents in the immediate posttransplant period. As evidence and experience evolved over time, much useful information became available about the optimal use of these agents. Understandably, mTOR-I effects wound healing through their antiproliferative properties. However, there are a lot of other immunological and nonimmunological factors which can also contribute to wound healing complications. These risk factors include obesity, uremia, increasing age, diabetes, smoking, alcoholism, and protein-energy malnutrition. Except for age, the rest of all these risk factors are modifiable. At the same time, mycophenolic acid derivatives, steroids, and antithymocyte globulin (ATG) have also been implicated in wound healing complications. A lot has been learnt about the optimal dose of mTOR-I and their trough levels, its combinations with other immunosuppressive medications, and patients' profile, enabling clinicians to use these agents appropriately for maximum benefits. Recent randomized control trials have further increased the confidence of clinicians to use these agents in immediate posttransplant periods. |
format | Online Article Text |
id | pubmed-8901320 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-89013202022-03-08 Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities Mabood Khalil, Muhammad Abdul Al-Ghamdi, Saeed M. G Dawood, Ubaidullah Shaik Ahmed Khamis, Said Sayed Ishida, Hideki Chong, Vui Heng Tan, Jackson J Transplant Review Article Mammalian target of rapamycin inhibitors (mTOR-I) lacks nephrotoxicity, has antineoplastic effects, and reduces viral infections in kidney transplant recipients. Earlier studies reported a significant incidence of wound healing complications and lymphocele. This resulted in the uncomfortable willingness of transplant clinicians to use these agents in the immediate posttransplant period. As evidence and experience evolved over time, much useful information became available about the optimal use of these agents. Understandably, mTOR-I effects wound healing through their antiproliferative properties. However, there are a lot of other immunological and nonimmunological factors which can also contribute to wound healing complications. These risk factors include obesity, uremia, increasing age, diabetes, smoking, alcoholism, and protein-energy malnutrition. Except for age, the rest of all these risk factors are modifiable. At the same time, mycophenolic acid derivatives, steroids, and antithymocyte globulin (ATG) have also been implicated in wound healing complications. A lot has been learnt about the optimal dose of mTOR-I and their trough levels, its combinations with other immunosuppressive medications, and patients' profile, enabling clinicians to use these agents appropriately for maximum benefits. Recent randomized control trials have further increased the confidence of clinicians to use these agents in immediate posttransplant periods. Hindawi 2022-02-28 /pmc/articles/PMC8901320/ /pubmed/35265364 http://dx.doi.org/10.1155/2022/6255339 Text en Copyright © 2022 Muhammad Abdul Mabood Khalil et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Mabood Khalil, Muhammad Abdul Al-Ghamdi, Saeed M. G Dawood, Ubaidullah Shaik Ahmed Khamis, Said Sayed Ishida, Hideki Chong, Vui Heng Tan, Jackson Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities |
title | Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities |
title_full | Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities |
title_fullStr | Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities |
title_full_unstemmed | Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities |
title_short | Mammalian Target of Rapamycin Inhibitors and Wound Healing Complications in Kidney Transplantation: Old Myths and New Realities |
title_sort | mammalian target of rapamycin inhibitors and wound healing complications in kidney transplantation: old myths and new realities |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901320/ https://www.ncbi.nlm.nih.gov/pubmed/35265364 http://dx.doi.org/10.1155/2022/6255339 |
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