New advances in antirejection therapy

Current Opinion in Cardiology

Volumn 22, Issue 2, 2007, Pages 117-122

  Chan, Michael ^a   Pearson, Glen J ^a  

^a UNIVERSITY OF ALBERTA HOSPITAL   (Canada)

Author keywords

Heart transplantation; Immunosuppressive drugs; Rejection

Indexed keywords

AZATHIOPRINE; BASILIXIMAB; CORTICOSTEROID; CYCLOSPORIN; CYCLOSPORIN A; DACLIZUMAB; EVEROLIMUS; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; IMMUNOGLOBULIN; IMMUNOGLOBULIN G; LYMPHOCYTE ANTIBODY; METHYLPREDNISOLONE; MONOCLONAL ANTIBODY; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; OKT 3; POLYCLONAL ANTIBODY; PREDNISONE; RAPAMYCIN; RITUXIMAB; STEROID; TACROLIMUS;

CARDIAC GRAFT REJECTION; CATARACT; CLINICAL TRIAL; CORTICOSTEROID INDUCED OSTEOPOROSIS; CREATININE BLOOD LEVEL; CYTOKINE RELEASE SYNDROME; CYTOMEGALOVIRUS INFECTION; DIABETES MELLITUS; DRUG ACTIVITY; DRUG EFFICACY; DRUG MECHANISM; DRUG SAFETY; DRUG SUBSTITUTION; DRUG WITHDRAWAL; FOLLOW UP; GRAFT SURVIVAL; HEART MUSCLE BIOPSY; HEART TRANSPLANTATION; HERPES; HERPES SIMPLEX; HUMAN; HYPERLIPIDEMIA; HYPERTENSION; IMMUNOPATHOLOGY; INHIBITION KINETICS; LYMPHOMA; OPPORTUNISTIC INFECTION; PHOTOTHERAPY; PLASMAPHERESIS; PRIORITY JOURNAL; REVIEW; SIDE EFFECT; TREATMENT OUTCOME;

ACUTE DISEASE; ADRENAL CORTEX HORMONES; ANTIBODIES, MONOCLONAL; CALCINEURIN; GRAFT REJECTION; HEART TRANSPLANTATION; HUMANS; IMMUNOSUPPRESSIVE AGENTS; SIROLIMUS; TACROLIMUS;

EID: 33846855757     PISSN: 02684705     EISSN: None     Source Type: Journal    
DOI: 10.1097/HCO.0b013e32802bf772     Document Type: Review

References (35)

1. Taylor DO, Edwards LB, Boucek MM, et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-third official adult heart transplantation report - 2006. J Heart Lung Transplant 2006; 25:869-879. This annual comprehensive report of heart transplantation has useful worldwide statistics.
2. Caves PK, Stinson EB, Billingham ME. Serial transvenous biopsy of the transplanted human heart. Lancet 1974; 2:821-826.
3. Billingham ME. Diagnosis of cardiac rejection by endomyocardial biopsy. Heart Transplant 1982; 1:25-30.
4. Stewart S, Winters GL, Fishbein MC, et al. Revision of the 1990 working formulation for the standardization of nomenclature in the diagnosis of heart rejection. J Heart Lung Transplant 2005; 11:1710-1720. This important paper describes the new ISHLT classification of cellular rejection and also includes a description of humoral rejection.
5. Fishbein MC, Kobashigawa J. Biopsy-negative cardiac transplant rejection: etiology, diagnosis, and therapy. Curr Opin Cardiol 2004; 19:166-169.
6. Deng MC, Eisen HJ, Mehra MR, et al., for the CARGO Investigators. Noninvasive discrimination of rejection in cardiac allograft recipients using gene expression profiling. Am J Transplant 2006; 6:150-160. Innovative study of the detection of cardiac rejection by a gene chip.
7. Halloran PF, Gourishankar S. Principles and overview of immunosuppression. In: Norman DJ, Turka LA, editors. Primer on transplantation, 2nd ed. Mount Laurel: American Society of Transplantation; 2001. pp. 87-98.
8. Eisen HJ, Hobbs RE, Davis SF, et al. Safety tolerability and efficacy of cyclosporine microemulsion in heart transplant recipients: a randomized multicenter doubleblind comparison with the oil-based formulation of cyclosporine: results at 24 months after transplantation. Transplantation 2001; 71:70-78.
9. Cantarovich M, Ross H, Arizón JM, et al. A 12-month, multicenter, randomized, adaptive design, open-label study to evaluate the benefit of C2-hr monitoring of Neoral on safety and efficacy outcomes in de novo cardiac transplant recipients receiving basiliximab induction [abstract]. Am J Transplant 2005; 11 (Suppl):249.
10. Delgado DH, Rao V, Hamel J, et al. Monitoring of cyclosporine 2-h postdose levels in heart transplantation: improvement in clinical outcomes. J Heart Lung Transplant 2005; 24:1343-1346. This small study shows that C2 monitoring of cyclosporine levels is feasible and may lead to improved rejection profiles.
11. Kobashigawa JA, Miller LW, Russell SD, et al. Tacrolimus with mycophenolate mofetil (MMF) or sirolimus vs. cyclosporine with MMF in cardiac transplant patients: 1-year report. Am J Transplant 2006; 6:1377-1386. An important multicenter randomized controlled trial of three different immunosuppressive regimens in de-novo heart transplant patients.
12. Grimm M, Rinaldi M, Yonan NA, et al. Superior prevention of acute rejection by tacrolimus vs. cyclosporine in heart transplant recipients: a large European trial. Am J Transplant 2006; 6:1387-1397. An important multicenter randomized controlled trial of tacrolimus versus cyclosporine in de-novo heart transplant patients.
13. Lubitz SA, Baran DA, Alwarshetty MM, et al. Long-term results of tacrolimus monotherapy in cardiac transplant recipients. J Heart Lung Transplant 2006; 25:699-706. This single center study gives preliminary support to tacrolimus monotherapy. Randomized studies are ongoing.
14. Opelz G, Dohler B, Laux G, for the Collaborative Transplant Study. Long-term prospective study of steroid withdrawal in kidney and heart transplant recipients. Am J Transplant 2005; 5:720-728. This large registry of both heart and kidney transplant patients indicates it is safe to wean appropriate patients off steroids.
15. Rosenbaum DH, Adams BC, Mitchell JD, et al. Effects of early steroid withdrawal after heart transplantation. Ann Thorac Surg 2006; 82:637-644.
16. Morris RE, Hoyt EG, Eugui EM, Allison AC. Prolongation of rat heart allograft survival by RS-61443. Surg Forum 1989; 40:337.
17. Kobashigawa J, Miller L, Renlund D, et al. A randomized active-controlled trial of mycophenolate mofetil in heart transplant recipients. Mycophenolate Mofetil Investigators. Transplantation 1998; 66:507-515.
18. Eisen HJ, Kobashigawa J, Keogh A, et al. Three-year results of a randomized, double-blind, controlled trial of mycophenolate mofetil versus azathioprine in cardiac transplant recipients. J Heart Lung Transplant 2005; 24:517-525. This is a 3-year follow-up report of the first large-scale trial of immunosuppressive therapy in heart transplantation.
19. Kobashigawa JA, Tobis JM, Mentzer RM, et al. Mycophenolate mofetil reduces intimal thickness by intravascular ultrasound after heart transplant: reanalysis of the multicenter trial. Am J Transplant 2006; 6:993-997. A previous intravascular ultrasound study of cardiac allograft vasculopathy failed to show any benefit of MMF over azathioprine. This report uses a more accurate analysis method.
20. Eisen HJ, Tuzcu EM, Dorent R, et al. Everolimus for the prevention of allograft rejection and vasculopathy in cardiac-transplant recipients. N Engl J Med 2003; 349:847-858.
21. Eisen H. Long-term cardiovascular risk in transplantation: insights from the use of everolimus in heart transplantation. Nephrol Dial Transplant 2006; 21 (suppl_3):iii9-iii13. This reports the 4-year follow-up of the important everolimus randomized controlled study.
22. Keogh A, Richardson M, Ruygrok P, et al. Sirolimus in de novo heart transplant recipients reduces acute rejection and prevents coronary heart disease at 2 years: a randomized clinical trial. Circulation 2004; 110:2694-2700.
23. Billingham ME, Cary NRB, Hammond ME, et al. A working formulation for the standardization of nomenclature in the diagnosis of heart and lung rejection. J Heart Lung Transplant 1990; 9:587-593.
24. Patel JK, Fishbein MC, Oeser BT, et al. Justification of the newly proposed ISHLT biopsy grading scale by combining 1A, 1B, and 2 into one mild rejection grade [abstract]. J Heart Lung Transplant 2005; 24 (Suppl 1):S66.
25. Kaufman DB, Shapiro R, Lucey MR, et al. Immunosuppression: practice and trends. Am J Transplant 2004; 4 (Suppl 9):38-53.
26. Chan MC, Kwok BW, Shiba N, et al. Conversion of cyclosporine to tacrolimus for refractory or persistent myocardial rejection. Transplant Proc 2002; 34:1850-1852.
27. Swinnen LJ, Costanzo-Nordin MR, Fisher SG. Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiac transplant recipients. New Engl J Med 1990; 323:1723-1728.
28. Oertel SH, Verschuuren E, Reinke P, et al. Effect of anti-CD 20 antibody rituximab in patients with posttransplant lymphoproliferative disorder (PTLD). Am J Transplant 2005; 5:2901-2906.
29. Keren A, Hayes HM, O'Driscoll G. Late humoral rejection in a cardiac transplant recipient treated with the anti-CD20 monoclonal antibody rituximab. Transplant Proc 2006; 38:1520-1522. A recent case report of successful treatment of humoral rejection with rituximab.
30. Aranda JM Jr, Scornik JC, Normann SJ, et al. Anti-CD20 monoclonal antibody (rituximab) therapy for acute cardiac humoral rejection: a case report. Transplantation 2002; 73:907-910.
31. Garrett HE Jr, Duvall-Seaman D, Helsley B, Groshart K. Treatment of vascular rejection with rituximab in cardiac transplantation. J Heart Lung Transplant 2005; 24:1337-1342. A recent case series of patients with humoral rejection treated successfully with rituximab.
32. Jordan SC, Quartel AW, Czer LS, et al. Posttransplant therapy using highdose human immunoglobulin (intravenous gammaglobulin) to control acute humoral rejection in renal and cardiac allograft recipients and potential mechanism of action. Transplantation 1998; 66:800-805.
33. Grauhan O, Knosalla C, Ewert R, et al. Plasmapheresis and cyclophosphamide in the treatment of humoral rejection after heart transplantation. J Heart Lung Transplant 2001; 20:316-321.
34. Schweiger M, Wasler A, Prenner G, et al. Late acute cardiac allograft rejection: new therapeutic options? Transplant Proc 2005; 37:4528-4531.
35. Kirklin JK, Brown RN, Huang ST, et al. Rejection with hemodynamic compromise: objective evidence for efficacy of photopheresis. J Heart Lung Transplant 2006; 25:283-288. This study provides objective evidence that photopheresis works in severe rejection.