Multidisciplinary Insights on Clinical Guidance for the Use of Proliferation Signal Inhibitors in Heart Transplantation

Andreas Zuckermann, Nicolas Manito, Eric Epailly, Arnt Fiane, Christoph Bara, Juan F. Delgado, Hans Lehmkuhl, Heather Ross, Howard Eisen, Jeremy Chapman, Hannah Valantine

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Abstract

Proliferation signal or mammalian target-of-rapamycin inhibitors (PSI/mTOR inhibitors), everolimus and sirolimus, provide attractive options for use in heart transplantation because they are immunosuppressive and anti-proliferative. PSI/mTOR inhibitors work synergistically with calcineurin inhibitors (CNIs) and thus permit the minimization of CNIs without compromising efficacy. This approach is advantageous for the majority of heart transplant recipients and might provide particular benefit in specific cases, such as patients with cardiac allograft vasculopathy, malignancies and renal dysfunction, or in patients intolerant to other immunosuppressive agents. Drawing on the expertise of transplant cardiologists, cardiac surgeons and nephrologists, we addressed the assessment of renal function; management of adverse events associated with this class of drugs; and clinical guidance, specifically for the use of everolimus, including patient selection, indications for treatment and practicalities of drug initiation and monitoring.

Original languageEnglish (US)
Pages (from-to)141-149
Number of pages9
JournalJournal of Heart and Lung Transplantation
Volume27
Issue number2
DOIs
StatePublished - Feb 1 2008

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Zuckermann, A., Manito, N., Epailly, E., Fiane, A., Bara, C., Delgado, J. F., Lehmkuhl, H., Ross, H., Eisen, H., Chapman, J., & Valantine, H. (2008). Multidisciplinary Insights on Clinical Guidance for the Use of Proliferation Signal Inhibitors in Heart Transplantation. Journal of Heart and Lung Transplantation, 27(2), 141-149. https://doi.org/10.1016/j.healun.2007.08.014