Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
Transplantation. 2018 Feb;102(2S Suppl 1):S27-S29. doi: 10.1097/TP.0000000000001921.
This brief overview discusses recent data on the use of mammalian target of rapamycin (mTOR) inhibitors in heart transplantation. Trials on de novo use have shown good efficacy of mTOR inhibitors; however, adverse events are often seen. Conversion protocols in long-term patients are mainly used in patients with renal insufficiency. Calcineurin inhibitor minimization and conversion to calcineurin inhibitor-free protocols have proven to stabilize renal function in recent trials. Lastly, beneficial effects of mTORs against the development of graft vasculopathy, cytomeglovirus infection and malignancy have been shown. Nevertheless, lower tolerability of the drug has affected the long-term use in patients. Future consideration of using mTORs will be individualized protocols in special subpopulation after heart transplantation.
本文简要综述了雷帕霉素靶蛋白（mTOR）抑制剂在心脏移植中的应用的最新数据。关于新用途的试验表明 mTOR 抑制剂具有良好的疗效；但是，也经常出现不良反应。长期患者的转换方案主要用于肾功能不全的患者。最近的试验证明，钙调磷酸酶抑制剂的最小化和转换为无钙调磷酸酶抑制剂方案可稳定肾功能。最后，mTOR 对移植物血管病、巨细胞病毒感染和恶性肿瘤的发展具有有益作用。然而，药物的耐受性较低，影响了患者的长期使用。未来在心脏移植后，将考虑针对特殊亚群制定个体化的 mTOR 使用方案。
