AIM: To determine the clinical reasons for conversion to everolimus (EVL) and long-term outcomes in heart transplant (HT) recipients. METHODS: A retrospective 12-mo study has been carried out in 14 Spanish centres to assess the efficacy and safety of conversion to EVL in maintenance HT recipients. RESULTS: Two hundred and twenty-two patients were included (mean age: 53 ± 10.5 years; mean time from HT: 8.1 ± 4.5 years). The most common reasons for conversion were nephrotoxicity (30%), chronic allograft vasculopathy (20%) and neoplasms (17%). The doses and mean levels of EVL at baseline (conversion to EVL) and after one year were 1.3 ± 0.3 and 1.2 ± 0.6 mg/d and 6.4 ± 3.4 and 5.6 ± 2.5 ng/mL, respectively. The percentage of patients receiving calcineurin inhibitors (CNIs) at baseline and on the final visit was 95% and 65%, respectively. The doses and mean levels of CNIs decreased between baseline and month 12 from 142.2 ± 51.6 to 98.0 ± 39.4 mg/d (P < 0.001) and from 126.1 ± 50.9 to 89.2 ± 47.7 ng/mL (P < 0.001), respectively, for cyclosporine, and from 2.9 ± 1.8 to 2.6 ± 1.9 mg/d and from 8.3 ± 4.0 to 6.5 ± 2.7 ng/mL (P = 0.011) for tacrolimus. In the subgroup of patients converted because of nephrotoxicity, creatinine clearance increased from 34.9 ± 10.1 to 40.4 ± 14.4 mL/min (P < 0.001). There were 37 episodes of acute rejection in 24 patients (11%). The most frequent adverse events were oedemas (12%), infections (9%) and gastrointestinal problems (6%). EVL was suspended in 44 patients (20%). Since the database was closed at the end of the study, no further follow-up data is available. CONCLUSION: Conversion to EVL in maintenance HT recipients allowed minimisation or suspension of the CNIs, with improved kidney function in the patients with nephrotoxicity, after 12 mo.
AIM: To determine the clinical reasons for conversion to everolimus (EVL) and long-term outcomes in heart transplant (HT) recipients. METHODS: A retrospective 12-mo study has been carried out in 14 Spanish centres to assess the efficacy and safety of conversion to EVL in maintenance HT recipients. RESULTS: Two hundred and twenty-two patients were included (mean age: 53 ± 10.5 years; mean time from HT: 8.1 ± 4.5 years). The most common reasons for conversion were nephrotoxicity (30%), chronic allograft vasculopathy (20%) and neoplasms (17%). The doses and mean levels of EVL at baseline (conversion to EVL) and after one year were 1.3 ± 0.3 and 1.2 ± 0.6 mg/d and 6.4 ± 3.4 and 5.6 ± 2.5 ng/mL, respectively. The percentage of patients receiving calcineurin inhibitors (CNIs) at baseline and on the final visit was 95% and 65%, respectively. The doses and mean levels of CNIs decreased between baseline and month 12 from 142.2 ± 51.6 to 98.0 ± 39.4 mg/d (P < 0.001) and from 126.1 ± 50.9 to 89.2 ± 47.7 ng/mL (P < 0.001), respectively, for cyclosporine, and from 2.9 ± 1.8 to 2.6 ± 1.9 mg/d and from 8.3 ± 4.0 to 6.5 ± 2.7 ng/mL (P = 0.011) for tacrolimus. In the subgroup of patients converted because of nephrotoxicity, creatinine clearance increased from 34.9 ± 10.1 to 40.4 ± 14.4 mL/min (P < 0.001). There were 37 episodes of acute rejection in 24 patients (11%). The most frequent adverse events were oedemas (12%), infections (9%) and gastrointestinal problems (6%). EVL was suspended in 44 patients (20%). Since the database was closed at the end of the study, no further follow-up data is available. CONCLUSION: Conversion to EVL in maintenance HT recipients allowed minimisation or suspension of the CNIs, with improved kidney function in the patients with nephrotoxicity, after 12 mo.
Authors: Lars Gullestad; Svend-Aage Mortensen; Hans Eiskjær; Gerdt C Riise; Lena Mared; Oystein Bjørtuft; Björn Ekmehag; Kjell Jansson; Svein Simonsen; Einar Gude; Bengt Rundqvist; Hans E Fagertun; Dag Solbu; Martin Iversen Journal: Transplantation Date: 2010-12-27 Impact factor: 4.939
Authors: F Gonzalez-Vilchez; J A Vazquez de Prada; M J Paniagua; M Gomez-Bueno; J M Arizon; L Almenar; E Roig; J Delgado; J L Lambert; F Perez-Villa; M L Sanz-Julve; M Crespo-Leiro; J Segovia; A Lopez-Granados; L Martinez-Dolz; S Mirabet; P Escribano; B Diaz-Molina; M Farrero; T Blasco Journal: Int J Cardiol Date: 2013-11-23 Impact factor: 4.164
Authors: H J Eisen; J Kobashigawa; R C Starling; D F Pauly; A Kfoury; H Ross; S-S Wang; B Cantin; A Van Bakel; G Ewald; S Hirt; H Lehmkuhl; A Keogh; M Rinaldi; L Potena; A Zuckermann; G Dong; C Cornu-Artis; P Lopez Journal: Am J Transplant Date: 2013-02-22 Impact factor: 8.086
Authors: S Arora; A K Andreassen; B Andersson; F Gustafsson; H Eiskjaer; H E Bøtker; G Rådegran; E Gude; D Ioanes; D Solbu; V Sigurdardottir; G Dellgren; I Erikstad; O G Solberg; T Ueland; P Aukrust; L Gullestad Journal: Am J Transplant Date: 2015-03-17 Impact factor: 8.086
Authors: W Schuler; R Sedrani; S Cottens; B Häberlin; M Schulz; H J Schuurman; G Zenke; H G Zerwes; M H Schreier Journal: Transplantation Date: 1997-07-15 Impact factor: 4.939
Authors: Markus A Engelen; Susanne Amler; Henryk Welp; Christian Vahlhaus; Stefan Gunia; Juergen R Sindermann; Markus Rothenburger; Joerg Stypmann Journal: Transplantation Date: 2011-05-27 Impact factor: 4.939
Authors: Maaike A Sikma; Claudine C Hunault; Johannes H Kirkels; Marianne C Verhaar; Jozef Kesecioglu; Dylan W de Lange Journal: Eur J Drug Metab Pharmacokinet Date: 2018-06 Impact factor: 2.441