Rapidly progressive cardiac allograft vasculopathy in early onset regressed with everolimus treatment in an adult cardiac recipient

Int Heart J. 2012;53(6):388-90. doi: 10.1536/ihj.53.388.

Abstract

A 60-year-old man with severe heart failure underwent an orthotopic heart transplant. Maintenance immunosuppression consisted of a calcineurin inhibitor, mycophenolate mofetil (MMF), and a glucocorticoid. Six months after the transplantation, coronary angiography (CAG) and intravascular ultrasound sonography (IVUS) showed rapidly progressive cardiac allograft vasculopathy (CAV) along with acute cellular rejection. Methylprednisone pulse therapy resulted in the resolution of acute rejection. MMF was exchanged for everolimus (EVL) and 6 months after EVL therapy, CAG and IVUS revealed the regression of CAV. EVL can improve established CAV as well as prevent the progression of CAV.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents
  • Biopsy
  • Cardiomyopathy, Dilated / surgery*
  • Coronary Angiography
  • Everolimus
  • Follow-Up Studies
  • Graft Rejection / diagnosis
  • Graft Rejection / etiology*
  • Graft Rejection / prevention & control
  • Heart Transplantation*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Myocardium / pathology*
  • Sirolimus / analogs & derivatives*
  • Sirolimus / therapeutic use
  • Time Factors
  • Ultrasonography, Interventional

Substances

  • Antineoplastic Agents
  • Immunosuppressive Agents
  • Everolimus
  • Sirolimus