Impact of Everolimus and Low-Dose Ciclosporin on Cytomegalovirus Replication and Disease in Pediatric Renal Transplantation.

B. Höcker,¹ S. Zencke,¹ L. Pape,² K. Krupka,¹ L. Kösters,¹ A. Fichtner,¹ L. Dello Strologo,² I. Guzzo,² R. Topaloglu,² B. Kranz,² J. König,² M. Bald,² N. Webb,² A. Noyan,² H. Dursun,² S. Marks,² Z. Ozcakar,² F. Thiel,² H. Billing,² M. Pohl,² H. Fehrenbach,² P. Schnitzler,¹ T. Bruckner,¹ L. Weber,² R. Feneberg,² T. Ahlenstiehl-Grunow,² B. Tönshoff.¹

¹University Children's Hospital, Heidelberg, Germany
²Certain Research Community, Germany, Italy, Turkey, United Kingdom.

Meeting: 2016 American Transplant Congress

Abstract number: D147

Keywords: Cytomeglovirus, Infection, Kidney transplantation, Pediatric

Session Information

Session Name: Poster Session D: Kidney-Pediatrics

Session Type: Poster Session

Date: Tuesday, June 14, 2016

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Purpose: Preclinical studies indicate an anti-cytomegalovirus (CMV) activity of the mammalian target of rapamycin inhibitor (mTORi) everolimus (EVR), but data in pediatric renal transplant recipients are lacking.

Methods: In the framework of the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) Registry, we thus analyzed the impact of EVR-based immunosuppressive therapy on CMV replication and disease in a large cohort (n = 301) of pediatric kidney allograft recipients.

Results: The EVR cohort (n = 59), who also received low-dose ciclosporin, was compared with a control cohort (n = 242), who was administered standard-dose ciclosporin or tacrolimus and an anti-metabolite, mostly mycophenolate mofetil (91.7%). Multivariate analysis revealed an 83% lower risk of CMV replication in the EVR cohort than in the control cohort (p = 0.005). In CMV high-risk (D+/R-) patients (n = 88), the EVR-based regimen was associated with a significantly lower rate of CMV disease (0% vs. 14.3%, p = 0.046) than the standard regimen. In patients who had received chemoprophylaxis with (val-)ganciclovir (n = 63), the CMV-free survival rates at 1 year and 3 years post-transplant (100%) were significantly (p = 0.015) higher in the EVR cohort (n = 15) than in the control cohort (n = 48; 1 year, 75.0%; 3 years, 63.3%) .

Conclusions: Our data suggest that in patients at high risk of CMV infection the use of EVR and low-dose ciclosporin is associated with a lower incidence of CMV disease compared to a standard-dose calcineurin inhibitor-based regimen.

CITATION INFORMATION: Höcker B, Zencke S, Pape L, Krupka K, Kösters L, Fichtner A, Dello Strologo L, Guzzo I, Topaloglu R, Kranz B, König J, Bald M, Webb N, Noyan A, Dursun H, Marks S, Ozcakar Z, Thiel F, Billing H, Pohl M, Fehrenbach H, Schnitzler P, Bruckner T, Weber L, Feneberg R, Ahlenstiehl-Grunow T, Tönshoff B. Impact of Everolimus and Low-Dose Ciclosporin on Cytomegalovirus Replication and Disease in Pediatric Renal Transplantation. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Höcker B, Zencke S, Pape L, Krupka K, Kösters L, Fichtner A, Strologo LDello, Guzzo I, Topaloglu R, Kranz B, König J, Bald M, Webb N, Noyan A, Dursun H, Marks S, Ozcakar Z, Thiel F, Billing H, Pohl M, Fehrenbach H, Schnitzler P, Bruckner T, Weber L, Feneberg R, Ahlenstiehl-Grunow T, Tönshoff B. Impact of Everolimus and Low-Dose Ciclosporin on Cytomegalovirus Replication and Disease in Pediatric Renal Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-everolimus-and-low-dose-ciclosporin-on-cytomegalovirus-replication-and-disease-in-pediatric-renal-transplantation/. Accessed July 6, 2025.

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