Pediatric utilization of rapamycin for severe cardiac allograft rejection

Pediatric utilization of rapamycin for severe cardiac allograft rejection

Straatman LP; Coles JG

Transplantation

2000

Child; Female; Humans; Adult; Animals; Acute Disease; Rabbits; Safety; Platelet Count; dosage; Antilymphocyte Serum/administration &; Cyclosporine/administration &; derivatives; dosage/adverse effects/therapeutic use; dosage/analogs &; Graft Rejection/drug therapy/etiology/pathology; Heart Transplantation/adverse effects; Immunosuppressive Agents/administration &; Methotrexate/administration &; Methylprednisolone/administration &; Mycophenolic Acid/administration &; Prednisone/administration &; Sirolimus/administration &; T-Lymphocytes/immunology; Tacrolimus/administration &

BACKGROUND: Rapamycin is a new immunosuppressive agent that has been shown to be effective in the treatment of acute cardiac rejection in the adult population. METHODS: This case documents a pediatric patient with ongoing cardiac rejection that did not abate despite treatment with antithymocyte serum (RATS), corticosteroid pulses, and methotrexate in addition to daily prednisone, mycophenolate mofetil, and tacrolimus. RESULTS: Initiation of therapy with rapamycin resulted in a rapid resolution of cardiac rejection and reduction of concomitant immunosuppressive agents and few side effects. CONCLUSIONS: This case illustrated the utilization of rapamycin in a pediatric patient with ongoing acute rejection despite several modifications in treatment.

2000

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