Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

23 October 2018 : Original article  

Everolimus Use for Intolerance or Failure of Baseline Immunosuppression in Adult Heart and Lung Transplantation

Shelby E. Kelsh1ABCDEF, Reda Girgis12ADE, Michael Dickinson12ADE, Jennifer K. McDermott12ABCDEF*

DOI: 10.12659/AOT.910952

Ann Transplant 2018; 23:744-750

Abstract

BACKGROUND: Everolimus can be utilized after heart or lung transplantation to reduce calcineurin inhibitor associated nephrotoxicity, due to cell cycle inhibitor adverse effects, and as adjunct therapy for rejection, cardiac allograft vasculopathy, and bronchiolitis obliterans syndrome.

MATERIAL AND METHODS: A single-center, retrospective cohort study was conducted including 51 adult heart transplant patients (n=32) and lung transplant patients (n=19) started on everolimus due to immunosuppressive therapy intolerance or failure, between 2010 and 2017. Everolimus indication, response, efficacy, and tolerability were assessed.

RESULTS: Everolimus was most commonly initiated due to leukopenia/neutropenia (n=17, 33%) or renal dysfunction (n=13, 25%). Leukopenia/neutropenia resolved in 76% of patients (13 out of 17 patients). Renal function (GFR) increased 7.4 mL/min from baseline to 3 months after everolimus initiation (P=0.011). The most common adverse effects were edema (n=23, 45%) and hyperlipidemia (n=25, 49%). A high discontinuation rate was observed (n=21, 41%), mostly from edema.

CONCLUSIONS: Everolimus might be beneficial in heart and lung transplant patients with leukopenia or neutropenia and lead to modest, short-term renal function improvement. Patient selection is crucial because adverse effects frequently lead to everolimus discontinuation.

Keywords: Heart Transplantation, Immunosuppressive Agents, Leukopenia, Lung Transplantation, renal insufficiency

Add Comment 0 Comments

In Press

Original article  

Engraftment Syndrome in Autologous Hematopoietic Stem Cell Transplant Patients: Incidence, Associated Risk ...

Ann Transplant In Press; DOI: 10.12659/AOT.944043  

Original article  

Comparative Study of Acute Kidney Injury in Liver Transplantation: Donation after Circulatory Death versus ...

Ann Transplant In Press; DOI: 10.12659/AOT.944077  

Original article  

Abnormal Liver Biopsies of Donor Grafts in Pediatric Liver Transplantation: How Do They Fare?

Ann Transplant In Press; DOI: 10.12659/AOT.944245  

Original article  

Kidney After Lung Transplants or Combined Kidney–Lung Transplantation: A Single-Center Retrospective Cohort...

Ann Transplant In Press; DOI: 10.12659/AOT.944049  

Most Viewed Current Articles

05 Apr 2022 : Original article   12,433

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

22 Nov 2022 : Original article   9,299

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

12 Jan 2022 : Original article   8,875

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

15 Mar 2022 : Case report   6,675

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358