Cardiovascular disease remains the commonest cause of death in kidney transplant recipients. Although some studies suggest that Mammalian target of rapamycin (mTOR) inhibitors may reduce ventricular hypertrophy, as well as prevent or alleviate atherosclerosis in kidney transplant recipients, these effects remain controversial. The objective of this study is to compare the effect of everolimus versus tacrolimus on left ventricular mass index (LVMI) and carotid intima media thickness (CIMT) after one year of treatment.

Material and Methods: This prospective, open-label, randomized, controlled trial was conducted at a single center between May 2012 and July 2014. After 12±4 weeks of initial immunosuppression with tacrolimus, mycophenolate sodium and prednisone, 48 de novo kidney transplant recipients with no evidence of rejection or inflammation on biopsy were randomly assigned at a 1:1 ratio to receive either standard tacrolimus-based (TACRO group -25 patients) or everolimus-based (EVERO group – 23 patients) maintenance immunosuppressive regimens. Clinical and laboratory data were collected at randomization and 3, 6, 9 and 12 months thereafter, and echocardiography was performed at randomization and 6 and 12 months thereafter.

Results: At one year, the EVERO group showed significantly reduced CIMT (p=0.012), despite higher proteinuria and cholesterol levels. CIMT reduction was almost two-fold greater in the EVERO group than in the TACRO group (p=0.0528). LVMI did not differ between groups. Renal function was excellent and similar between groups.

Conclusion: Everolimus reduced CIMT at one year in renal transplant recipients. Everolimus may contribute to reducing cardiovascular mortality in kidney transplant recipients in the long term.

CITATION INFORMATION: Garcia P, Takase H, Nga H, Contti M, Hueb J, Morales-Buenrostro L. Everolimus Reduces Carotid Intima-Media Thickness in Renal Transplant Recipients After One Year: Randomized Controlled Trial. Am J Transplant. 2017;17 (suppl 3).

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