 This study investigated the effects of MTOR inhibition on autophagy and renal transplants under routine clinical conditions. Electron microscopy showed a significant increase in potasitic autophagosomal volume fractions and patients treated with sirolimus. Transcriptomic profiling of laser-captured microtesected glomeruli did not reveal any changes in autophagy-related genes. Immunotistochemical evaluation of autophagic degradation product P62 was unchanged while there was a significant increase in potasitic LC3 positivity in biopsies of sirolimus-treated patients. The results suggest an association between MTOR inhibition and autophagosome formation in transplant patients, however further research is needed to determine whether this represents an increase in autophagic flux or simply an accumulation of autophagosomes. This article was authored by Sagar Bayana, Arpita Basin Tree, Thomas D. Kramer and others.