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1.
Transplant Proc ; 42(1): 324-7, 2010.
Article in English | MEDLINE | ID: mdl-20172342

ABSTRACT

The increasing number of heart transplant recipients receiving immunosuppression with mammalian target of rapamycin inhibitors prompted the implementation of a South American Transplant Physicians Group to register these patients in a database. Everolimus (EVL) is a signal proliferation inhibition that reduces graft vascular disease when used de novo. Recently, its administration has expanded to subjects with resistant rejection or with side effects due to other immunosuppressive drugs (calcineurin inhibitors and/or steroids), allowing for better regulation of the immunosuppressive regimen. Herein we have shown the data collected from patients receiving EVL in ten South American Heart Transplant Centers. We have concluded that the administration of EVL is a useful adjunctive therapy that allows the reduction or suspension of other immunosuppressive drugs that caused unwanted side effects, without a loss of immunosuppressive efficacy, with manageable side effects, and constituting a valuable therapeutic option.


Subject(s)
Heart Transplantation/immunology , Heart Transplantation/statistics & numerical data , Immunosuppressive Agents/therapeutic use , Registries/statistics & numerical data , Sirolimus/analogs & derivatives , Adolescent , Adrenal Cortex Hormones/adverse effects , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Child , Cyclosporine/therapeutic use , Everolimus , Female , Heart Transplantation/adverse effects , Humans , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Sirolimus/therapeutic use , South America , Tacrolimus/therapeutic use
3.
Transplant Proc ; 38(3): 937-42, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16647515

ABSTRACT

Despite improvements during the last decades, heart transplantation remains associated with several medical complications, which limit clinical outcomes: acute rejection with hemodynamic compromise, cytomegalovirus (CMV) infections, allograft vasculopathy, chronic renal failure, and neoplasias. Everolimus, a proliferation signal inhibitor, represents a new option for adjunctive immunosuppressive therapy. Everolimus displays better efficacy in de novo heart transplant patients than azathioprine for prophylaxis of biopsy-proven acute rejection episodes of at least ISHLT grade 3A (P < .001), of allograft vasculopathy (P < .01), and of CMV infections (P < .01). These findings suggest that everolimus potentially play an important role as part of immunosuppressive therapy in heart transplant recipients. Heart transplant investigators from Latin America produced recommendations for everolimus use in daily practice based on available data and their own experience.


Subject(s)
Heart Transplantation/immunology , Immunosuppressive Agents/therapeutic use , Sirolimus/analogs & derivatives , Consensus Development Conferences as Topic , Cyclosporine/administration & dosage , Cyclosporine/therapeutic use , Drug Therapy, Combination , Everolimus , Humans , Immunosuppressive Agents/pharmacokinetics , Immunosuppressive Agents/standards , Latin America , Safety , Sirolimus/pharmacokinetics , Sirolimus/standards , Sirolimus/therapeutic use
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