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. 2015 Dec 24;5(4):310-9.
doi: 10.5500/wjt.v5.i4.310.

Twelve-month efficacy and safety of the conversion to everolimus in maintenance heart transplant recipients

Nicolás Manito  1 , Juan F Delgado  1 , María G Crespo-Leiro  1 , José María Arizón  1 , Javier Segovia  1 , Francisco González-Vílchez  1 , Sònia Mirabet  1 , Ernesto Lage  1 , Domingo Pascual-Figal  1 , Beatriz Díaz  1 , Jesús Palomo  1 , Gregorio Rábago  1 , Marisa Sanz  1 , Teresa Blasco  1 , Eulàlia Roig  1
Affiliations

Twelve-month efficacy and safety of the conversion to everolimus in maintenance heart transplant recipients

Nicolás Manito et al. World J Transplant. .

Abstract

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.

Keywords: Everolimus; Heart transplantation; Mammalian target of rapamycin inhibitors; Nephrotoxicity; Renal failure.

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Figures

Figure 1
Figure 1
Evolution of kidney function during the study. CrCl: Creatinine clearance; EVL: Everolimus.
See this image and copyright information in PMC

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References

    1. Lund LH, Edwards LB, Kucheryavaya AY, Benden C, Christie JD, Dipchand AI, Dobbels F, Goldfarb SB, Levvey BJ, Meiser B, et al. The registry of the International Society for Heart and Lung Transplantation: thirty-first official adult heart transplant report--2014; focus theme: retransplantation. J Heart Lung Transplant. 2014;33:996–1008. - PubMed
    1. Griffiths MH, Crowe AV, Papadaki L, Banner NR, Yacoub MH, Thompson FD, Neild GH. Cyclosporin nephrotoxicity in heart and lung transplant patients. QJM. 1996;89:751–763. - PubMed
    1. Ippoliti G, Rinaldi M, Pellegrini C, Viganò M. Incidence of cancer after immunosuppressive treatment for heart transplantation. Crit Rev Oncol Hematol. 2005;56:101–113. - PubMed
    1. Ojo AO, Held PJ, Port FK, Wolfe RA, Leichtman AB, Young EW, Arndorfer J, Christensen L, Merion RM. Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med. 2003;349:931–940. - PubMed
    1. Epailly E, Albanell J, Andreassen A, Bara C, Campistol JM, Delgado JF, Eisen H, Fiane AE, Mohacsi P, Schubert S, et al. Proliferation signal inhibitors and post-transplant malignancies in heart transplantation: practical clinical management questions. Clin Transplant. 2011;25:E475–E486. - PubMed

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