Background-Conversion to mTORi is used in patients with renal insufficiency following liver transplantation (LT), especially in those with calcineurin inhibitor (CNI) associated nephrotoxicity.
Aims—We conducted a systematic review of all randomized controlled trials (RCTs) to test the hypothesis that conversion from CNI to mTORi is associated with an improvement in renal function at 1 year in LT recipients with renal insufficiency.
Methods—We performed a search of all of the major databases, conference proceedings and relevant journals until January 2017. A random effects model was utilized to determine the pooled estimate of the change in renal function and pooled risk estimates of adverse events that associated with mTORi based therapy at 1 year.
Results—Thirteen studies from twelve RCTs met the final inclusion criteria. A significant improvement of the mean GFR (SMD 0.42, 95% CI 0.26–0.58) and the mean change in GFR (SMD 0.32, 95% CI 0.15–0.50) at 1 year was observed. However, the conversion strategy was related to more infections (RR 1.21, 95%CI, 1.10-1.32) and drug discontinuations (RR 1.82, 95%CI 1.38-2.4).