Pediatric utilization of rapamycin for severe cardiac allograft rejection.
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.
Straatman
L P
LP
Department of Cardiology, The Hospital for Sick Children, University of Toronto, Canada.
Coles
J G
JG
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
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D011241:Prednisone; D020123:Sirolimus; D016559:Tacrolimus; D008775:Methylprednisolone; D008727:Methotrexate