title: Everolimus-related pulmonary toxicity in heart transplant recipients.
abstract: Pulmonary toxicity (PT) is emerging as a frequent and serious complication of sirolimus, a proliferation signal inhibitor (PSI) used in solid-organ transplantation. Everolimus is a more recently developed PSI with molecular structure very similar to that of sirolimus. Surprisingly, although experience with everolimus is increasing and becoming substantial, there remains very little information about everolimus-related PT. Herein we report 2 heart transplant recipients who developed a non-infectious pulmonary syndrome after everolimus treatment was started. Transbronchial pulmonary biopsy specimens showed typical interstitial pneumonitis, and everolimus discontinuation resulted in rapid clinical and radiological improvement. Although PT seems to be more common after sirolimus exposure, everolimus is by no means spared from this potentially lethal complication and should always be suspected in the relevant clinical setting.
authors.affiliation: Cardiac Failure and Heart Transplantation Unit, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain. vicast79@hotmail.com
authors.forename: Victor
authors.initials: V
authors.lastname: Expósito
authors.forename: Jose A Vázquez
authors.initials: JA
authors.lastname: de Prada
authors.forename: Jose J
authors.initials: JJ
authors.lastname: Gómez-Román
authors.forename: Francisco
authors.initials: F
authors.lastname: González-Vilchez
authors.forename: Miguel
authors.initials: M
authors.lastname: Llano-Cardenal
authors.forename: Tamara
authors.initials: T
authors.lastname: García-Camarero
authors.forename: Mónica
authors.initials: M
authors.lastname: Fernández-Valls
authors.forename: Javier
authors.initials: J
authors.lastname: Ruano
authors.forename: Rafael
authors.initials: R
authors.lastname: Martín-Durán
mesh_terms: D000368:Aged; D001706:Biopsy; D000068338:Everolimus; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008168:Lung / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus