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Webster AC et al. – TOR–I have been evaluated in four different primary immunosuppressive algorithms: as replacement for CNI and antimetabolites, in combination with CNI at low and high doses, and with a variable dose of CNI. Generally, surrogate endpoints for graft survival favor TOR–I (lower risk of acute rejection and higher GFR), and surrogate endpoints for patient outcomes are worsened by TOR–I (bone marrow suppression and lipid disturbance). Long–term hard–endpoint data from methodologically robust randomized trials are still required.

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