The survival of heart transplant recipients using cyclosporine and everolimus is not inferior to that using cyclosporine and mycophenolate.
BACKGROUND
Heart transplantation has become the best available therapy for patients with refractory end-stage heart failure. Cyclosporine (CsA) and mycophenolate mofetil (MMF) are the 2 FDA-approved drugs to prevent posttransplant acute rejection episodes. The purpose of this study was to evaluate the result of heart transplantation treated with CsA and everolimus (EVL), compared with that of patients treated with CsA and MMF.


METHODS
From 2000 to 2009 heart transplantation was performed in 239 patients among whom we enrolled 93 patients with a serum creatinine values<or=2.8 mg/dL after informed written consents. The 2 arms were a CE group, who received EVL (n=46) CsA, and steroid (n=46), and a CM group who received MMF, CsA, and steroid (n=47).


RESULTS
There was no operative mortality in either groups. The 1- and 5-year survivals of the CE group were 97.67+/-2.22% and 80.23+/-6.87%, versus the CM group, 97.72+/-2.17% and 79.38+/-7.62%, respectively. There was significant difference between the 2 groups.


CONCLUSIONS
Survival after heart transplantation under EVL or MMF plus CsA and steroid was good. The survival of patients under the regimen of EVL, CsA and, steroid was not inferior to that of subjects prescribed MMF, CsA and steroid up to 5 years.
Wang
S-S
SS
Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan. wangp@ntu.edu.tw
Chou
N-K
NK
Chi
N-H
NH
Huang
S-C
SC
Wu
I-H
IH
Wang
C-H
CH
Yu
H-Y
HY
Chen
Y-S
YS
Tsao
C-I
CI
Ko
W-J
WJ
Shun
C-T
CT
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000276:immunology* / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015996:Survival Rate; D013997:Time Factors
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000068338:Everolimus; D009173:Mycophenolic Acid; D020123:Sirolimus