Premium
Rapamycin as Rescue Therapy in a Patient Supported by Biventricular Assist Device to Heart Transplantation With Consecutive Ongoing Rejection
Author(s) -
Ankersmit H. J.,
Roth G.,
Zuckermann A.,
Moser B.,
Obermaier R.,
Taghavi S.,
Brunner M.,
Wieselthaler G.,
Lanzenberger M.,
Ullrich R.,
Laufer G.,
Grimm M.,
Wolner E.
Publication year - 2003
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1034/j.1600-6143.2003.00030.x
Subject(s) - medicine , heart transplantation , transplantation , immunosuppression , concomitant , apheresis , cardiac allograft vasculopathy , ventricular assist device , surgery , heart failure , platelet
Rapamycin is a new immunosuppressive agent that has been shown to be effective in acute heart allograft rejection. This case documents a patient suffering from cardiac sarcoidosis who was bridged to transplantation for 90 days with ongoing rejection after allograft implantation. Rejection did not abate despite treatment with antithymocyte globulin (ATG), FK506, a mycophenolate switch and courses of multiple apheresis. Initiation of rapamycin treatment resulted in a rapid resolution of cardiac rejection and reduction of concomitant immunosuppressive agents with few side‐effects. Most notably was the reduction of panel reactive antibodies within a few weeks after the rapamycin initiation. This case illustrates that the utilization of rapamycin ceased ongoing rejection in a patient with a clear hyperimmune state despite prior extensive utilization of a variety of immunosuppressive strategies after heart transplantation .