Supplementary Administration of Everolimus Reduces Cardiac Systolic Function in Kidney Transplant Recipients

Background: The effect of everolimus, one of the mammalian targets of rapamycin inhibitors, on cardiac function was evaluated in kidney transplant recipients. Material/Methods: Seventy-six participants who underwent kidney transplant between March 2009 and May 2016 were retrospectively reviewed. To standardize everolimus administration, the following criteria were used: (1) the recipient did not have a donor-specific antigen before kidney transplantation; (2) the recipient did not have proteinuria and uncontrollable hyperlipidemia after kidney transplantation; and (3) acute rejection was not observed on protocol biopsy 3 months after kidney transplantation. According to these criteria, everolimus administration for maintenance immunosuppression after kidney transplantation was included. Cardiac function was compared between the treatment group (n= 30) and non-treatment group (n= 46). Results: The mean observation periods of the treatment and non-treatment groups were 41.3 +/- 12.6 and 43.9 +/- 19.8 months, respectively (p= 0.573). The mean ejection fraction and fractional shortening of the treatment and non-treatment groups after kidney transplant were 66.5 +/- 7.9% vs. 69.6 +/- 5.5% (p= 0.024) and 37.1 +/- 6.2% vs. 39.3 +/- 4.7% (p= 0.045), respectively. In the treatment group, the mean ejection fraction and fractional shortening before and after kidney transplantation did not differ significantly (p= 0.604 and 0.606, respectively). In the non-treatment group, the mean ejection fraction and fractional shortening before and after kidney transplantation differed significantly (p= 0.004 and 0.006, respectively). Conclusions: Supplementary administration of everolimus after kidney transplantation can reduce cardiac systolic function.