title: Pediatric utilization of rapamycin for severe cardiac allograft rejection.
abstract: BACKGROUND
  Rapamycin is a new immunosuppressive agent that has been shown to be effective in the treatment of acute cardiac rejection in the adult population.
  
  
  METHODS
  This case documents a pediatric patient with ongoing cardiac rejection that did not abate despite treatment with antithymocyte serum (RATS), corticosteroid pulses, and methotrexate in addition to daily prednisone, mycophenolate mofetil, and tacrolimus.
  
  
  RESULTS
  Initiation of therapy with rapamycin resulted in a rapid resolution of cardiac rejection and reduction of concomitant immunosuppressive agents and few side effects.
  
  
  CONCLUSIONS
  This case illustrated the utilization of rapamycin in a pediatric patient with ongoing acute rejection despite several modifications in treatment.
authors.affiliation: Department of Cardiology, The Hospital for Sick Children, University of Toronto, Canada.
authors.forename: L P
authors.initials: LP
authors.lastname: Straatman
authors.forename: J G
authors.initials: JG
authors.lastname: Coles
mesh_terms: D000208:Acute Disease; D000328:Adult; D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D002648:Child; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008727:Methotrexate / Q000008:administration & dosage; D008775:Methylprednisolone / Q000008:administration & dosage; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D010976:Platelet Count; D011241:Prednisone / Q000008:administration & dosage; D011817:Rabbits; D012449:Safety; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013601:T-Lymphocytes / Q000276:immunology; D016559:Tacrolimus / Q000008:administration & dosage
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D011241:Prednisone; D020123:Sirolimus; D016559:Tacrolimus; D008775:Methylprednisolone; D008727:Methotrexate