Everolimus-incorporated immunosuppressant strategy improves renal dysfunction while maintaining low rejection rates after heart transplantation in Japanese patients
2013 (English)In: International Heart Journal, ISSN 1349-2365, Vol. 54, no 4, 222-227 p.Article in journal (Refereed) Published
The long-term survival of heart transplantation (HTx) recipients has increased significantly in recent years, however, the nephrotoxic adverse effects of calcineurin inhibitors (CNIs) are still a major concern. Recently, an inhibitor of mammalian target of rapamycin, everolimus (EVL), has emerged as an alternative immunosuppressant drug that may allow CM dosage reduction and thereby spare renal function. Data were collected from 20 HTx recipients who had received EVL (target trough level 3-8 ng/mL) along with a dose reduction of CNIs and/or mycophenolate mophetil (MMF) and had been followed for 1 year. Estimated glomerular filtration rate increased significantly with a reduction in the CM dosage in a dose-dependent manner (P less than 0.001, r = -0.807). Neutrophil count increased significantly (P less than 0.05) with a reduction in the dosage of MMF (P = 0.009, r = -0.671). Cytomegalovirus antigenemia remained negative after EVL administration among all candidates without any antiviral agents (P = 0.001). There were no significant increases in the acute rejection rates among recipients with EVL compared to those without EVL (P = 0.132). An immunosuppressant strategy incorporating EVL could reduce the CM and MMF dosages, which resulted in improvements in renal dysfunction and neutropenia while maintaining low rejection rates among HTx recipients.
Place, publisher, year, edition, pages
International Heart Journal Association , 2013. Vol. 54, no 4, 222-227 p.
Renal function; Mycophenolate mophetil; Calcineurin inhibitor
IdentifiersURN: urn:nbn:se:liu:diva-111182ISI: 000324603600008PubMedID: 23924935OAI: oai:DiVA.org:liu-111182DiVA: diva2:754530
Funding Agencies|FUGAKU Trust for Medicinal Research; Japanese Heart Foundation; Japanese Association for CerebroCardiovascular Disease Control; AstraZeneca; Pfizer Health Research Foundation; Japan Society for the Promotion of Science 2014-10-102014-10-102014-10-27Bibliographically approved