title: Recommendations for use of everolimus after heart transplantation: results from a Latin-American Consensus Meeting.
abstract: Despite improvements during the last decades, heart transplantation remains associated with several medical complications, which limit clinical outcomes: acute rejection with hemodynamic compromise, cytomegalovirus (CMV) infections, allograft vasculopathy, chronic renal failure, and neoplasias. Everolimus, a proliferation signal inhibitor, represents a new option for adjunctive immunosuppressive therapy. Everolimus displays better efficacy in de novo heart transplant patients than azathioprine for prophylaxis of biopsy-proven acute rejection episodes of at least ISHLT grade 3A (P < .001), of allograft vasculopathy (P < .01), and of CMV infections (P < .01). These findings suggest that everolimus potentially play an important role as part of immunosuppressive therapy in heart transplant recipients. Heart transplant investigators from Latin America produced recommendations for everolimus use in daily practice based on available data and their own experience.
authors.affiliation: Institutions of the participants of the Consensus Meeting: Heart Institute, Heart Failure and Heart Transplantation Unit, São Paulo, Brazil. dcleedimar@incor.usp.br
authors.forename: E A
authors.initials: EA
authors.lastname: Bocchi
authors.forename: L
authors.initials: L
authors.lastname: Ahualli
authors.forename: M
authors.initials: M
authors.lastname: Amuchastegui
authors.forename: F
authors.initials: F
authors.lastname: Boullon
authors.forename: B
authors.initials: B
authors.lastname: Cerutti
authors.forename: R
authors.initials: R
authors.lastname: Colque
authors.forename: D
authors.initials: D
authors.lastname: Fernandez
authors.forename: A
authors.initials: A
authors.lastname: Fiorelli
authors.forename: P
authors.initials: P
authors.lastname: Olaya
authors.forename: N
authors.initials: N
authors.lastname: Vulcado
authors.forename: S V
authors.initials: SV
authors.lastname: Perrone
mesh_terms: D003245:Consensus Statements as Topic; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000068338:Everolimus; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics / Q000592:standards / Q000627:therapeutic use*; D007843:Latin America; D012449:Safety; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000592:standards / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000068338:Everolimus; D020123:Sirolimus