Grimm, Kathrin;
Lehner, Anja;
Fernandez Rodriguez, Silvia;
Orban, Madeleine;
Fischer, Marcus;
Rosenthal, Laura L.;
Jakob, Andre;
Haas, Nikolaus A.;
Dalla Pozza, Robert;
Kozlik‐Feldmann, Rainer;
Ulrich, Sarah M.
Conversion to everolimus in pediatric heart transplant recipients is a safe treatment option with an impact on cardiac allograft vasculopathy and renal function
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Media type:
E-Article
Title:
Conversion to everolimus in pediatric heart transplant recipients is a safe treatment option with an impact on cardiac allograft vasculopathy and renal function
Contributor:
Grimm, Kathrin;
Lehner, Anja;
Fernandez Rodriguez, Silvia;
Orban, Madeleine;
Fischer, Marcus;
Rosenthal, Laura L.;
Jakob, Andre;
Haas, Nikolaus A.;
Dalla Pozza, Robert;
Kozlik‐Feldmann, Rainer;
Ulrich, Sarah M.
Published:
Wiley, 2021
Published in:
Clinical Transplantation, 35 (2021) 3
Language:
English
DOI:
10.1111/ctr.14191
ISSN:
1399-0012;
0902-0063
Origination:
Footnote:
Description:
AbstractBackgroundCardiac allograft vasculopathy (CAV) and nephrotoxicity affect long‐term survival after heart transplantation (HTX). Studies, mostly conducted in adults, showed a positive effect of everolimus (EVL) on these problems. We describe the effects of conversion of the immunosuppressive therapy to an everolimus including regime on CAV, renal function, and safety in heart transplanted children/adolescents.MethodsThis retrospective single‐center study included 36 participants (mean time after HTX 6.3 ± 4.7 years). Descriptive pre/post‐comparisons were performed with an observation period partially up to 4 years. Impact on CAV was assessed based on intravascular imaging and Stanford grading. Safety analysis included cytomegalovirus (CMV)‐infection and acute rejection.ResultsIn terms of CAV (9 out of 36 patients) four showed no progression, three an improvement, one a worsening; one new diagnosis. The average CrCl showed a significant improvement 6, 12, and 24 months after conversion regarding all patients (n = 29). There was no acute rejection or CMV‐infection.ConclusionConversion to an EVL‐based therapy after pediatric HTX is a safe immunosuppressive regime without increasing risk of acute rejection or CMV‐infection. There was some evidence of reduction in progression of CAV and a significant improvement of the renal function.