The Efficacy of Everolimus in Liver Transplant Patients

Document Type

Conference Proceeding

Publication Date

6-1-2023

Publication Title

Am J Transplant

Abstract

Purpose: The objective of our study is to illuminate the long term impact of everolimus on renal function in liver transplant patients in a real world setting. Methods: We completed a single institution, retrospective chart review of patients who had a liver transplant from 2013-2020. 774 patients were included and everolimus status was noted. Everolimus use was classified as: “never used”, “ongoing use”, and “short-term use”. Additionally, glomerular filtration rates (GFR) and creatinine values were noted for 2 months, 1 year, and 3 years post-transplant. Patient outcomes including survival were evaluated. A logistic regression was performed for discrete time to event (death) model with varying covariates (GFR <60 and everolimus status). We also calculated means, hazard ratios (HR), and odds ratios (OR) for comparisons. Results: Of 774 patients, 496 were never on everolimus, 162 were briefly on the medication, and 116 were actively taking it. 277 patients were female. The average time patients were on the medication was 3.32 months with a standard deviation (SD) of 0.40, ranging from 0-69.08 months. Race was categorized into African American (85 patients), White (570 patients), Asian (13 patients), and other (106 patients). The average age was 55.51 years for patients who were never on everolimus, 58.99 years for short-term use, and 57.66 years for ongoing everolimus use. The use of everolimus had a marginal effect on GFR <60 (P=0.07). The status of ongoing use was trending towards renal protection against a GFR <60 when compared with never on everolimus (HR=0.372, 95%CI=0.139- 0.999, P=0.08). Everolimus status had no impact on survival. One year survival for the ongoing treatment group compared to the never on group was not significantly different (HR=1.951, 95%CI=1.103-3.452, P=0.06). The three-year hazard ratio was 1.474 (95%CI=0.838-2.594, P=0.34) and the five-year hazard ratio was 1.37 (95%CI=0.752-2.496, P=0.44). Individuals that were not African American had an increased likelihood of survival (HR=0.544, 95%CI=0.355- 0.834, P <0.05). Finally, female sex increased the risk of a posttransplant GFR <60 (OR=2.87, 95%CI=1.78-4.68, P<0.05). Conclusions: Everolimus treatment status had no impact on survival. Ongoing everolimus treatment trended towards renal protection against GFR <60 compared to never using the medication. However, African American race decreased the likelihood of survival. Finally, female sex increased the risk of a GFR <60. Future studies evaluating everolimus over a longer period of time would be valuable. CITATION INFORMATION: Sreedhar S., Lu M., Moonka D., Jafri S. The Efficacy of Everolimus in Liver Transplant Patients AJT, Volume 23, Issue 6, Supplement 1. DISCLOSURES: S.Sreedhar: None. M.Lu: n/a. D.Moonka: None. S.Jafri: Speakers Bureau;; Gilead, Takeda, Abbvie.

PubMed ID

Not assigned.

Volume

23

Issue

Suppl 1

First Page

S855

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