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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 24, 2015; 5(4): 338-347
Published online Dec 24, 2015. doi: 10.5500/wjt.v5.i4.338
Published online Dec 24, 2015. doi: 10.5500/wjt.v5.i4.338
Combining cytochrome P-450 3A4 modulators and cyclosporine or everolimus in transplantation is successful
Fernando González, Ricardo Valjalo, Department of Nephrology, Faculty of Medicine, Universidad de Chile, Hospital del Salvador, Santiago 7500922, Chile
Author contributions: González F designed the study; González F and Valjalo R collected the clinical and laboratory information, performed the data analysis and wrote the manuscript.
Institutional review board statement: Servicio de Salud Metropolitano Oriente´s Comité de Ética Científica approved the study protocol and the informed consent form as it is detailed in the approval document.
Informed consent statement: Servicio de Salud Metropolitano Oriente´s Comité de Ética Científica approved the study protocol and the informed consent form as it is detailed in the approval document. All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: González F: Transplant medical advisor at Novartis, Chile, From April 2014 up to date. Valjalo R: Nothing to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fernando González, MD, MBA, Department of Nephrology, Faculty of Medicine, Universidad de Chile, Hospital del Salvador, Avenida Salvador 364, Providencia, Santiago 7500922, Chile. fgonzalf@uc.cl
Telephone: +56-2-29770522 Fax: +56-2-29770522
Received: July 2, 2015
Peer-review started: July 6, 2015
First decision: July 31, 2015
Revised: August 10, 2015
Accepted: September 16, 2015
Article in press: September 18, 2015
Published online: December 24, 2015
Processing time: 175 Days and 5.9 Hours
Peer-review started: July 6, 2015
First decision: July 31, 2015
Revised: August 10, 2015
Accepted: September 16, 2015
Article in press: September 18, 2015
Published online: December 24, 2015
Processing time: 175 Days and 5.9 Hours
Core Tip
Core tip: Several immunosuppressive (IS) drugs, used in clinical transplantation, are metabolized by the hepatic cytochrome P-450 system as many other drugs. The co-prescription of IS and ketoconazole reshapes the IS pharmacokinetics and appears to confer benefit to patients receiving calcineurin inhibitors (CNI) and mammalian target of rapamycin inhibitors. We describe the long term follow-up of kidney allograft recipients receiving ketoconazole with a CNI alone or combined with everolimus and report good graft and patient survivals and low rates of acute rejection episodes. These combinations, in low immunological risk kidney transplant recipients are feasible, effective, safe and affordable even in the long term.