心脏移植后依维莫司使用建议：拉丁美洲共识会议结果
Recommendations for use of everolimus after heart transplantation: results from a Latin-American Consensus Meeting.
作者信息
Bocchi E A, Ahualli L, Amuchastegui M, Boullon F, Cerutti B, Colque R, Fernandez D, Fiorelli A, Olaya P, Vulcado N, Perrone S V
机构信息
Institutions of the participants of the Consensus Meeting: Heart Institute, Heart Failure and Heart Transplantation Unit, São Paulo, Brazil.
出版信息
Transplant Proc. 2006 Apr;38(3):937-42. doi: 10.1016/j.transproceed.2006.02.049.
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.
尽管在过去几十年间有了改善，但心脏移植仍与多种医学并发症相关，这些并发症限制了临床疗效：伴有血流动力学损害的急性排斥反应、巨细胞病毒（CMV）感染、移植血管病变、慢性肾衰竭和肿瘤。依维莫司作为一种增殖信号抑制剂，是辅助免疫抑制治疗的一种新选择。在预防至少为国际心脏和肺移植学会（ISHLT）3A级活检证实的急性排斥反应发作、移植血管病变（P < 0.01）和CMV感染（P < 0.01）方面，依维莫司在初次心脏移植患者中显示出比硫唑嘌呤更好的疗效。这些发现表明，依维莫司作为免疫抑制治疗的一部分，可能在心脏移植受者中发挥重要作用。来自拉丁美洲的心脏移植研究人员根据现有数据和他们自己的经验，制定了依维莫司在日常实践中的使用建议。
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