Rapidly Progressive Cardiac Allograft Vasculopathy in Early Onset Regressed With Everolimus Treatment in an Adult Cardiac Recipient

Junichi Ishida; Koichiro Kinugawa; Taro Shiga; Teruhiko Imamura; Masaru Hatano; Hisataka Maki; Toshiro Inaba; Atsushi Yao; Yasunobu Hirata; Takashi Nishimura; Shunei Kyo; Minoru Ono; Ryozo Nagai

doi:10.1536/ihj.53.388

Case Reports

Rapidly Progressive Cardiac Allograft Vasculopathy in Early Onset Regressed With Everolimus Treatment in an Adult Cardiac Recipient

Junichi Ishida, Koichiro Kinugawa, Taro Shiga, Teruhiko Imamura, Masaru Hatano, Hisataka Maki, Toshiro Inaba, Atsushi Yao, Yasunobu Hirata, Takashi Nishimura, Shunei Kyo, Minoru Ono, Ryozo Nagai

Author information

Junichi Ishida
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Koichiro Kinugawa
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
Taro Shiga
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Teruhiko Imamura
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Masaru Hatano
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Hisataka Maki
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Toshiro Inaba
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Atsushi Yao
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Yasunobu Hirata
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Takashi Nishimura
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
Shunei Kyo
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo
Minoru Ono
Department of Cardiothoracic Surgery, Graduate School of Medicine, The University of Tokyo
Ryozo Nagai
Jichi Medical University

Keywords: Heart transplantation, Intravascular ultrasound sonography, Rejection

JOURNAL FREE ACCESS

2012 Volume 53 Issue 6 Pages 388-390

DOI https://doi.org/10.1536/ihj.53.388

Details

Abstract

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.

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