# Rapamycin and human longevity among kidney transplant recipients surviving the first year (paper 5th November 2026) **URL:** \ **Category:** General\ **Created:** [November 6, 2026, 8:50pm UTC](https://www.rapamycin.news/t/rapamycin-and-human-longevity-among-kidney-transplant-recipients-surviving-the-first-year-paper-5th-november-2026/27373 "2026-11-06T20:50:26Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![John\_Hemming](https://www.rapamycin.news/user_avatar/www.rapamycin.news/john_hemming/32/6542_2.png) [@John\_Hemming](https://www.rapamycin.news/u/John_Hemming)\ **Post date:** [November 6, 2026, 8:50pm UTC](https://www.rapamycin.news/t/rapamycin-and-human-longevity-among-kidney-transplant-recipients-surviving-the-first-year-paper-5th-november-2026/27373/1 "2026-11-06T20:50:26Z")
> **[Rapamycin and human longevity among kidney transplant recipients surviving...](https://link.springer.com/article/10.1007/s11357-026-02643-8)** > > Rapamycin, an mTOR inhibitor, continues to be investigated for hypothesized physiological, disease prevention, and longevity benefits, but few studies have been conducted in humans. Using US national organ transplant registry data, one of the largest... chatGPT(6max) s11357-026-02643-8.pdf, by Darren E. Stewart and William E. Fitzsimmons, examines rapamycin and survival after kidney transplantation. **My assessment: this is a useful long-term observational study showing no detectable survival advantage in a selected transplant population. Its relevance to healthy people taking intermittent rapamycin is limited, and its claim to novelty needs qualification.** The researchers analysed US transplant registry data for people transplanted between 2000 and 2007, following outcomes through December 2025. The main comparison included: - 4,885 recipients prescribed an mTOR inhibitor at discharge and at their first-year follow-up, predominantly sirolimus. - 6,589 recipients prescribed no mTOR inhibitor at either visit. - All participants had survived with a functioning transplanted kidney to the first-year visit and were receiving tacrolimus or cyclosporine. - Median follow-up was approximately 11.5 years, with 6,443 deaths overall. The groups initially differed in age, transplant year, accompanying medicines and other characteristics. The authors used propensity weighting to balance 18 measured factors. Their adjusted results were: | Analysis | Median survival age: mTOR inhibitor group | Comparison group | Difference, with 95% confidence interval | | --- | --- | --- | --- | | Follow-up stopped at kidney graft failure | 66.1 years | 66.7 years | -0.6 years, from -2.4 to 0.8 | | Follow-up continued after graft failure | 64.6 years | 64.3 years | 0.3 years, from -1.6 to 2.0 | Neither comparison showed a statistically significant difference. Alternative cohort definitions and analyses separating tacrolimus from cyclosporine produced broadly similar findings. These are estimated survival ages within a selected transplant population. They are not estimates of general population life expectancy. **The main novelty is the extended follow-up and presentation of survival on an age scale.** The study brings unusually long human follow-up to a question often discussed using animal experiments and short human trials. However, the claim that this is the first large retrospective study evaluating rapamycin and human lifespan is difficult to sustain without a much narrower definition: - **Isakova and colleagues, 2013:** analysed 139,370 US kidney transplant recipients, including mTOR inhibitor regimens, and examined mortality using adjusted and propensity-matched analyses. [PubMed](https://pubmed.ncbi.nlm.nih.gov/23025566/?utm_source=chatgpt.com) - **Badve and colleagues, 2016:** studied 9,353 adult recipients whose grafts survived at least one year. They examined mortality using both time-varying exposure and treatment recorded at fixed visits, finding higher mortality associated with mTOR inhibitor use. This is particularly relevant prior work because of its similar survivor restriction. [PubMed](https://pubmed.ncbi.nlm.nih.gov/27445164/?utm_source=chatgpt.com) - **Knoll and colleagues, 2014:** pooled individual patient data from 21 randomised trials involving 5,876 recipients. Sirolimus reduced malignancy but was associated with increased mortality. [The BMJ](https://www.bmj.com/content/349/bmj.g6679?utm_source=chatgpt.com) These studies used different treatment comparisons and follow-up periods, so the new analysis adds information. Nevertheless, the paper should explicitly discuss them and explain why its findings differ. None of these three important mortality studies appears in its reference list. The study’s strongest features are its large sample, substantial number of deaths, long follow-up, mortality linkage, explicit assessment of measured covariate balance, and several sensitivity analyses. Including follow-up after graft failure is especially valuable. The principal weaknesses are: 1. **The findings have limited applicability to otherwise healthy adults.** 2. **Long follow-up does not establish long-term continuous treatment.** 3. **Propensity weighting cannot remove all confounding.** 4. **Selection of first-year survivors narrows the question.** 5. **Stopping follow-up at graft failure complicates the primary analysis.** 6. **A non-significant result does not demonstrate equivalence.** 7. **The study cannot explain the biological reason for its result.** 8. **There are concrete reporting inconsistencies.** The paper supports a cautious statement: **among selected kidney transplant recipients surviving the first year, initial mTOR inhibitor prescribing was not associated with a clear improvement in adjusted long-term survival.** Demonstrating an effect on human ageing, or evaluating intermittent rapamycin in healthy adults, requires evidence that this study cannot provide.