Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schweiger, M; Wasler, A; Prenner, G; Tripolt, M; Schwarz, M; Tscheliessnigg, KH.
Late acute cardiac allograft rejection: new therapeutic options?
Transplant Proc. 2005; 37(10):4528-4531
Doi: 10.1016/j.transproceed.2005.11.053
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Schweiger Martin
- Co-Autor*innen der Med Uni Graz
- Andrä Michaela
- Prenner Günther
- Tscheliessnigg Karlheinz
- Wasler Andrae
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- Abstract:
- Background. Late acute cellular rejection is associated with decreased survival and the development of CAV. Among new immunosuppressive drugs introduced into clinical practice, everolimus, has been shown to be safe in cardiac transplantation. We report our experience with everolimus in heart transplant recipients who developed late acute cellular cardiac rejection. Methods. Patients with a history of previous rejection episodes who experienced cardiac rejection were switched to an everolimus, cyclosporine, and steroid immunosuppressive regimen. All patients had already received statins and antihypertensive medications. Everolimus, cyclosporine trough levels, and laboratory values were controlled monthly. Drug administration was adapted to an everolimus trough level between 3 and 8 ng/mL, mean maintenance dosage was 0.25 to 1.5 mg twice a day. Death, safety, side effects, biopsy-proven acute rejection episodes, laboratory values, and blood levels were evaluated retrospectively. Results. Four cardiac allograft recipients (two male, two female), at a median of 1473.25 days post-orthotopic heart transplantation (oHTx) (range = 65 to 3045), received 1 to 1.5 mg everolimus per day. Over a follow-up period of at least 2 month (range = 2 to 10) the mortality was 0%. The drug was well tolerated; no acute cellular rejection greater than grade 1a (ISHLT grading) was observed after 2 months. In one patient increased cholesterol values and in two others, elevated triglyceride levels were seen, but were controlled with increased statin therapy. No obvious increased creatinine values were seen with everolimus. Conclusion. In conclusion, conversion to an everolimus-based immunosuppressive regimen after late cardiac rejection is safe and effective; no major side effects were observed.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Cyclosporine - blood Cyclosporine - pharmacokinetics Cyclosporine - therapeutic use
- Drug Therapy, Combination -
- Female -
- Follow-Up Studies -
- Graft Rejection - drug therapy Graft Rejection - immunology Graft Rejection - prevention & control
- Heart Transplantation - immunology
- Humans -
- Immunosuppressive Agents - blood Immunosuppressive Agents - pharmacokinetics Immunosuppressive Agents - therapeutic use
- Male -
- Middle Aged -
- Sirolimus - analogs & derivatives Sirolimus - blood Sirolimus - pharmacokinetics Sirolimus - therapeutic use
- Time Factors -
- Transplantation, Homologous -