Comparison 4. Target of rapamycin inhibitors (TOR‐I) versus antimetabolites (AM): primary outcomes.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death	31	10482	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.84, 1.33]
2 Total graft loss	27	7626	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.93, 1.40]
3 Graft loss censored for death	26	8966	Risk Ratio (M‐H, Random, 95% CI)	1.09 [0.82, 1.45]
4 All acute rejection	31	10075	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.79, 1.02]
5 Biopsy‐proven acute rejection	24	10101	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.81, 1.12]
5.1 TOR‐I/reduced CNI versus AM/standard CNI	7	4170	Risk Ratio (M‐H, Random, 95% CI)	1.10 [0.87, 1.40]
5.2 TOR‐I/standard CNI versus AM/standard CNI	17	5931	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.74, 1.09]
6 CMV infection	25	10049	Risk Ratio (M‐H, Random, 95% CI)	0.44 [0.34, 0.58]
7 Adverse wound outcomes	20		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
7.1 All complications	17	6913	Risk Ratio (M‐H, Random, 95% CI)	1.56 [1.28, 1.91]
7.2 Lymphocoele	16	8415	Risk Ratio (M‐H, Random, 95% CI)	1.55 [1.32, 1.81]
8 All malignancies	17	8799	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.64, 1.07]
9 Number needing to change treatment	25	9747	Risk Ratio (M‐H, Random, 95% CI)	1.56 [1.28, 1.90]