Everolimus in Heart Transplantation: An Update
The evidence base relating to the use of everolimus in heart transplantation has expanded considerably in recent years, providing clinically relevant information regarding its use in clinical practice. Unless there are special considerations to take into account, all de novo heart transplant patient...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2013/683964 |
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| author | Stephan W. Hirt Christoph Bara Markus J. Barten Tobias Deuse Andreas O. Doesch Ingo Kaczmarek Uwe Schulz Jörg Stypmann Assad Haneya Hans B. Lehmkuhl |
| author_facet | Stephan W. Hirt Christoph Bara Markus J. Barten Tobias Deuse Andreas O. Doesch Ingo Kaczmarek Uwe Schulz Jörg Stypmann Assad Haneya Hans B. Lehmkuhl |
| author_sort | Stephan W. Hirt |
| collection | DOAJ |
| description | The evidence base relating to the use of everolimus in heart transplantation has expanded considerably in recent years, providing clinically relevant information regarding its use in clinical practice. Unless there are special considerations to take into account, all de novo heart transplant patients can be regarded as potential candidates for immunosuppression with everolimus and reduced-exposure calcineurin inhibitor therapy. Caution about the use of everolimus immediately after transplantation should be exercised in certain patients with the risk of severe proteinuria, with poor wound healing, or with uncontrolled severe hyperlipidemia. Initiation of everolimus in the early phase aftertransplant is not advisable in patients with severe pretransplant end-organ dysfunction or in patients on a left ventricular assist device beforetransplant who are at high risk of infection or of wound healing complications. The most frequent reason for introducing everolimus in maintenance heart transplant patients is to support minimization or withdrawal of calcineurin inhibitor therapy, for example, due to impaired renal function or malignancy. Due to its potential to inhibit the progression of cardiac allograft vasculopathy and to reduce cytomegalovirus infection, everolimus should be initiated as soon as possible after heart transplantation. Immediate and adequate reduction of CNI exposure is mandatory from the start of everolimus therapy. |
| format | Article |
| id | doaj-art-1778f3bc7fda49fcbe45dad40ac8c7a6 |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-1778f3bc7fda49fcbe45dad40ac8c7a62025-02-03T01:12:02ZengWileyJournal of Transplantation2090-00072090-00152013-01-01201310.1155/2013/683964683964Everolimus in Heart Transplantation: An UpdateStephan W. Hirt0Christoph Bara1Markus J. Barten2Tobias Deuse3Andreas O. Doesch4Ingo Kaczmarek5Uwe Schulz6Jörg Stypmann7Assad Haneya8Hans B. Lehmkuhl9Department of Cardiothoracic Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, GermanyDivision of Cardiovascular,Thoracic and Transplantation Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, GermanyDepartment of Cardiac Surgery, University Hospital Leipzig, Heart Center, 04289 Leipzig, GermanyDepartment of Cardiovascular Surgery, University Heart Center Hamburg, Martinistr 52, 20246 Hamburg, GermanyDepartment of Cardiology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, GermanyDepartment of Cardiac Surgery, Munich Transplantation Center, Klinikum Großhadern LMU, Marchioninistraße 15, 81377 Munich, GermanyDepartment of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Georgstraße 11, 32545 Bad Oeynhausen, GermanyDepartment of Cardiovascular Medicine, Division of Cardiology, Münster University Hospital, Albert-Schweitzer-Straße 33, 48149 Münster, GermanyDepartment of Cardiovascular Surgery, University Hospital Kiel, Arnold-Heller-Straße 7, 24105 Kiel, GermanyDepartment of Cardiovascular and Thoracic Surgery, German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyThe evidence base relating to the use of everolimus in heart transplantation has expanded considerably in recent years, providing clinically relevant information regarding its use in clinical practice. Unless there are special considerations to take into account, all de novo heart transplant patients can be regarded as potential candidates for immunosuppression with everolimus and reduced-exposure calcineurin inhibitor therapy. Caution about the use of everolimus immediately after transplantation should be exercised in certain patients with the risk of severe proteinuria, with poor wound healing, or with uncontrolled severe hyperlipidemia. Initiation of everolimus in the early phase aftertransplant is not advisable in patients with severe pretransplant end-organ dysfunction or in patients on a left ventricular assist device beforetransplant who are at high risk of infection or of wound healing complications. The most frequent reason for introducing everolimus in maintenance heart transplant patients is to support minimization or withdrawal of calcineurin inhibitor therapy, for example, due to impaired renal function or malignancy. Due to its potential to inhibit the progression of cardiac allograft vasculopathy and to reduce cytomegalovirus infection, everolimus should be initiated as soon as possible after heart transplantation. Immediate and adequate reduction of CNI exposure is mandatory from the start of everolimus therapy.http://dx.doi.org/10.1155/2013/683964 |
| spellingShingle | Stephan W. Hirt Christoph Bara Markus J. Barten Tobias Deuse Andreas O. Doesch Ingo Kaczmarek Uwe Schulz Jörg Stypmann Assad Haneya Hans B. Lehmkuhl Everolimus in Heart Transplantation: An Update Journal of Transplantation |
| title | Everolimus in Heart Transplantation: An Update |
| title_full | Everolimus in Heart Transplantation: An Update |
| title_fullStr | Everolimus in Heart Transplantation: An Update |
| title_full_unstemmed | Everolimus in Heart Transplantation: An Update |
| title_short | Everolimus in Heart Transplantation: An Update |
| title_sort | everolimus in heart transplantation an update |
| url | http://dx.doi.org/10.1155/2013/683964 |
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