Multiple indications for everolimus after liver transplantation in current clinical practice

Table 8 Future challenges in liver transplantation and the potential role of everolimus

Future challenges	Potential role of everolimus
More marginal donors	Renal function protection
Recipients with more serious disease, selected by MELD	Renal function protection
Recipients with more serious disease, with metabolic syndrome	Prevention of cardiovascular events
Less HCV cirrhosis but more aggressive strains	Antifibrotic effect
More NASH	Prevention of cardiovascular events
More metabolic syndrome during follow-up	Prevention of cardiovascular events
More HCC recurrence	Antiproliferative effect
More de novo tumours	Antiproliferative effect
CNIe-related neurotoxicity	Good neurological profile

MELD: Model for end-stage liver disease; HCV: Hepatitis C virus; NASH: Non-alcoholic steato hepatitis; HCC: Hepatocellular carcinoma; CNI: Calcineurine inhibitors.