Ishida Junichi, Kinugawa Koichiro, Shiga Taro, Imamura Teruhiko, Hatano Masaru, Maki Hisataka, Inaba Toshiro, Yao Atsushi, Hirata Yasunobu, Nishimura Takashi, Kyo Shunei, Ono Minoru, Nagai Ryozo
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Int Heart J. 2012;53(6):388-90. doi: 10.1536/ihj.53.388.
A 60-year-old man with severe heart failure underwent an orthotopic heart transplant. Maintenance immunosuppression consisted of a calcineurin inhibitor, mycophenolate mofetil (MMF), and a glucocorticoid. Six months after the transplantation, coronary angiography (CAG) and intravascular ultrasound sonography (IVUS) showed rapidly progressive cardiac allograft vasculopathy (CAV) along with acute cellular rejection. Methylprednisone pulse therapy resulted in the resolution of acute rejection. MMF was exchanged for everolimus (EVL) and 6 months after EVL therapy, CAG and IVUS revealed the regression of CAV. EVL can improve established CAV as well as prevent the progression of CAV.
一名60岁的严重心力衰竭男性接受了原位心脏移植。维持性免疫抑制包括一种钙调神经磷酸酶抑制剂、霉酚酸酯（MMF）和一种糖皮质激素。移植后6个月，冠状动脉造影（CAG）和血管内超声检查（IVUS）显示心脏移植血管病变（CAV）迅速进展并伴有急性细胞排斥反应。甲泼尼龙冲击疗法使急性排斥反应得到缓解。MMF被换成依维莫司（EVL），EVL治疗6个月后，CAG和IVUS显示CAV有所消退。EVL可改善已形成的CAV并预防CAV进展。
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