The Journal of Heart and Lung Transplantation
Volume 29, Issue 6 , Pages 641-647 , June 2010

Benefit of early conversion from CNI-based to everolimus-based immunosuppression in heart transplantation

  • Einar Gude, MD

      Affiliations

    • Department of Cardiology, Oslo University Hospital, Oslo, Norway
    • Corresponding Author InformationReprint requests: Einar Gude, MD, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo 0027, Norway. Telephone: +47-23-07-00-00. Fax: +47-23-07-19-50
    • ,
  • Lars Gullestad, MD, PhD

      Affiliations

    • Department of Cardiology, Oslo University Hospital, Oslo, Norway
    • Rikshospitalet and Faculty Division, University of Oslo, Oslo, Norway
    • ,
  • Satish Arora, MD

      Affiliations

    • Rikshospitalet and Faculty Division, University of Oslo, Oslo, Norway
    • ,
  • Svein Simonsen, MD, PhD

      Affiliations

    • Department of Cardiology, Oslo University Hospital, Oslo, Norway
    • ,
  • Ina Hoel, RN

      Affiliations

    • Department of Cardiology, Oslo University Hospital, Oslo, Norway
    • ,
  • Anders Hartmann, MD, PhD

      Affiliations

    • Rikshospitalet and Faculty Division, University of Oslo, Oslo, Norway
    • Department of Internal Medicine, Oslo University Hospital, Oslo, Norway
    • ,
  • Hallvard Holdaas, MD, PhD

      Affiliations

    • Department of Internal Medicine, Oslo University Hospital, Oslo, Norway
    • ,
  • Arnt E. Fiane, MD, PhD

      Affiliations

    • Rikshospitalet and Faculty Division, University of Oslo, Oslo, Norway
    • Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Oslo, Norway
    • ,
  • Odd R. Geiran, MD, PhD

      Affiliations

    • Rikshospitalet and Faculty Division, University of Oslo, Oslo, Norway
    • Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Oslo, Norway
    • ,
  • Arne K. Andreassen, MD, PhD

      Affiliations

    • Department of Cardiology, Oslo University Hospital, Oslo, Norway

References 

  1. Taylor DO, Edwards LB, Aurora P, et al. Registry of the International Society for Heart and Lung Transplantation: twenty-fifth official adult heart transplant report—2008. J Heart Lung Transplant. 2008;27:943–956
  2. Schmauss D, Weis M. Cardiac allograft vasculopathy: recent developments. Circulation. 2008;117:2131–2141
  3. Caforio AL, Tona F, Piaserico S, et al. C2 is superior to C0 as predictor of renal toxicity and rejection risk profile in stable heart transplant recipients. Transplant Int. 2005;1:116–124
  4. Arora S, Andreassen A, Simonsen S, et al. Prognostic importance of renal function 1 year after heart transplantation for all-cause and cardiac mortality and development of allograft vasculopathy. Transplantation. 2007;84:149–154
  5. Cantarovich M, Hirsh A, Alam A, et al. The clinical impact of an early decline in kidney function in patients following heart transplantation. Am J Transplant. 2009;9:348–354
  6. Chapman JR, Valantine H, Albanell J, et al. Proliferation signal inhibitors in transplantation: questions at the cutting edge of everolimus therapy. Transplant Proc. 2007;10:2937–2950
  7. Gustafsson F, Ross HJ. Proliferation signal inhibitors in cardiac transplantation. Curr Opin Cardiol. 2007;2:111–116
  8. Rothenburger M, Zuckermann A, Bara C, et al. Recommendations for the use of everolimus (Certican) in heart transplantation: results from the second German–Austrian Certican Consensus Conference. J Heart Lung Transplant. 2007;4:305–311
  9. Eisen HJ, Tuzcu EM, Dorent R, et al. Everolimus for the prevention of allograft rejection and vasculopathy in cardiac-transplant recipients. N Engl J Med. 2003;349:847–858
  10. Lehmkuhl HB, Mai D, Dandel M, et al. Observational study with everolimus (Certican) in combination with low-dose cyclosporine in de novo heart transplant recipients. J Heart Lung Transplant. 2007;7:700–704
  11. Meier-Kriesche HU, Schold J, Srinivas T, et al. Sirolimus in combination with tacrolimus is associated with worse renal allograft survival compared to mycophenolate mofetil combined with tacrolimus. Am J Transplant. 2005;5:2273–2280
  12. Meier-Kriesche , Steffen B, Chu A, et al. Sirolimus with neoral versus mycophenolate mofetil with neoral is associated with decreased renal allograft survival. Am J Transplant. 2004;4:2058–2066
  13. Moro López JA, Almenar L, Martínez-Dolz L, et al. Progression of renal dysfunction in cardiac transplantation after the introduction of everolimus in the immunosuppressive regime. Transplantation. 2009;87:538–541
  14. Lehmkuhl H, Hetzer R. Clinical experience with Certican (everolimus) in de novo heart transplant patients at the Deutsches Herzzentrum Berlin. J Heart Lung Transplant. 2005;24(suppl):S201–S205
  15. Rothenburger M, Teerling E, Bruch C, et al. Calcineurin inhibitor-free immunosuppression using everolimus (Certican) in maintenance heart transplant recipients: 6 months' follow-up. J Heart Lung Transplant. 2007;3:250–257
  16. Gonzalez-Vilchez F, de Prada JA, Exposito V, et al. Avoidance of calcineurin inhibitors with use of proliferation signal inhibitors in de novo heart transplantation with renal failure. J Heart Lung Transplant. 2008;10:1135–1141
  17. Holdaas H, Bentdal O, Pfeffer P, et al. Early, abrupt conversion of de novo renal transplant patients from cyclosporine to everolimus: results of a pilot study. Clin Transplant. 2008;3:366–371
  18. Watson CJ, Firth J, Williams P, et al. A randomized controlled trial of late conversion from CNI-based to sirolimus-based immunosuppression following renal transplantation. Am J Transplant. 2005;5:2496–2503
  19. Kovarik JM, Kalbag J, Figueiredo J, et al. Differential influence of two cyclosporine formulations on everolimus pharmacokinetics: a clinically relevant pharmacokinetic interaction. J Clin Pharmacol. 2002;42:95–99
  20. Gullestad L, Iversen M, Mortensen A. Everolimus with reduced calcineurin inhibitor in thoracic transplant recipients with reduced renal function: a multicenter, randomized trial. Transplantation (Epub ahead of print).
  21. Efficacy and Safety of Everolimus in Recipients of Heart Transplants to Prevent Acute and Chronic Rejection. Study NCT00300274. A 2310-study www.clinicaltrials.gov
  22. van Gelder T, Klupp J, Sawamoto T, et al. ATP-binding cassette transporters and calcineurin inhibitors: potential clinical implications. Transplant Proc. 2001;3:2420–2421
  23. Levey AS, Coresh J, Balk E, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003;139:137–147
  24. Bocchi EA, Ahualli L, Amuchastegui M, et al. Recommendations for use of everolimus after heart transplantation: results from a Latin-American Consensus Meeting. Transplant Proc. 2006;38:937–942
  25. Nankivell BJ, Borrows RJ, Fung CL, et al. Calcineurin inhibitor nephrotoxicity: longitudinal assessment by protocol histology. Transplantation. 2004;78:557–565
  26. Meiser B, Reichart B, Adamidis I, et al. First experience with de novo calcineurin-inhibitor-free immunosuppression following cardiac transplantation. Am J Transplant. 2005;4:827–831
  27. Zuckermann A, Manito N, Epailly E, et al. Multidisciplinary insights on clinical guidance for the use of proliferation signal inhibitors in heart transplantation. J Heart Lung Transplant. 2008;2:141–149
  28. Zakliczynski M, Nozynski J, Zakliczynska H, et al. Deterioration of renal function after replacement of cyclosporine with sirolimus in five patients with severe renal impairment late after heart transplantation. Transplant Proc. 2003;6:2331–2332
  29. Vitko S, Margreiter R, Weimar W, et al. Everolimus (Certican) 12-month safety and efficacy versus mycophenolate mofetil in de novo renal transplant recipients. Transplantation. 2004;78:1532–1540
  30. Stephany BR, Boumitri M, Budev M, et al. Absence of proteinuria predicts improvement in renal function after conversion to sirolimus-based immunosuppressive regimens in lung transplant survivors with chronic kidney disease. J Heart Lung Transplant. 2009;6:564–571

PII: S1053-2498(10)00037-9

doi: 10.1016/j.healun.2010.01.005

The Journal of Heart and Lung Transplantation
Volume 29, Issue 6 , Pages 641-647 , June 2010

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