Use of Everolimus After Multivisceral Transplantation: A Report of Two Cases

Rao, Bharat; Segovia, Maria Cristina; Kazimi, Marwan; Parekh, Ravish; Raoufi, Mohammad; Jafri, Syed-Mohammed

doi:10.1016/j.transproceed.2015.11.034

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…However, a significantly higher rate of wound dehiscence and reoperation was reported in sirolimus treated group (33.3% vs. 5%, p = 0.05). Similar outcomes were reported in other observational studies with sirolimus and one case series with everolimus 244–246 . In another case series of 22 patients, addition of mTORi to standard therapy allowed for the reduction of immunosuppression in majority (68.2%) of patients 326 …”

Section: Clinical Questions and Recommendationssupporting

confidence: 80%

“…Similar outcomes were reported in other observational studies with sirolimus and one case series with everolimus. [244][245][246] In another case series of 22 patients, addition of mTORi to standard therapy allowed for the reduction of immunosuppression in majority (68.2%) of patients. 326 mTORi offer a unique benefit in heart transplantation by decreasing incidence and/or reducing progression of CAV.…”

Section: Rejection or Chronic Graft Dysfunctionmentioning

confidence: 98%

“…109,231,234,235 In intestinal transplantation, corticosteroids are a standard component of early-and long-term M-IMS regimens as illustrated by observational studies that persistently include them as essential components of M-IMS in this population. 51,52,[54][55][56][150][151][152][153]194,[243][244][245][246] In heart transplantation, most patients are either maintained on corticosteroids or withdrawal is attempted at 3-6 months or greater post-transplant. [247][248][249][250][251][252] At 1 and 5 years post-transplant, 89% and 52% of recipients, respectively, continued to be maintained on corticosteroids.…”

Section: Recommendation 9 Evidence Summary: Corticosteroid Withdrawalmentioning

confidence: 99%

“…In intestinal transplantation , corticosteroids are a standard component of early‐ and long‐term M‐IMS regimens as illustrated by observational studies that persistently include them as essential components of M‐IMS in this population 51,52,54–56,150–153,194,243–246 …”

Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

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Consensus recommendations for use of maintenance immunosuppression in solid organ transplantation: Endorsed by the American College of Clinical Pharmacy, American Society of Transplantation, and the International Society for Heart and Lung Transplantation

et al. 2022

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Advances in maintenance immunosuppression over the past three decades have improved solid organ transplantation outcomes dramatically. Uninterrupted access to immunosuppression is paramount to minimize rejection and maintain allograft and patient survival. There is no standardized approach to maintenance immunosuppression management. Agents used vary based on transplanted organ, center‐specific protocol, provider expertise, insurance formularies, ability to cover co‐pays, recipient characteristics and tolerability. Published data reflects this heterogeneity. Despite this limitation, maintenance immunosuppression usage cross pollinates between organ groups with standard of care agents often being used off‐label, making medication access a challenge for many transplant recipients. A multidisciplinary panel of American transplant clinicians was formed to review published literature on maintenance immunosuppression with the goal to formulate consensus recommendations for their use in specific organ groups. These consensus recommendations are intended to provide transplant clinicians with a summary of literature on maintenance immunosuppression in the modern era and to support transplant team members working to secure medication access for patients.

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Section: Clinical Questions and Recommendationssupporting

confidence: 80%

Section: Rejection or Chronic Graft Dysfunctionmentioning

confidence: 98%

Section: Recommendation 9 Evidence Summary: Corticosteroid Withdrawalmentioning

confidence: 99%

Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

See 2 more Smart Citations

Consensus recommendations for use of maintenance immunosuppression in solid organ transplantation: Endorsed by the American College of Clinical Pharmacy, American Society of Transplantation, and the International Society for Heart and Lung Transplantation

et al. 2022

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“…As with OLT, emergent concepts will include the optimisation of patient selection criteria, as well as innovative neoadjuvant/adjuvant concepts to abrogate disease recurrence and monitor for allograft dysfunction. For example, recent case reports have detailed the use of everolimus post-MVT in 2 NET patients in attempts to suppress recurrence whilst avoiding the nephrotoxicity of calcineurin inhibitors[ 52 ], as well as the use of PRRT to stabilise disease prior to MMVT which also included simultaneous transplantation of a sentinel skin flap from the organ donor to aid monitoring of rejection and tailoring of immunosuppression regimens[ 13 ].…”

Section: Intestinal and Multivisceral Transplantationmentioning

confidence: 99%

Liver transplantation and multivisceral transplantation in the management of patients with advanced neuroendocrine tumours

Clift

Frilling

2018

WJG

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Orthotopic liver transplantation (OLT) represents a generally accepted albeit somewhat controversially discussed therapeutic strategy in highly selected patients with non-resectable hepatic metastases from neuroendocrine tumours (NET). Whilst there are some exclusion criteria, these are not universally followed, and the optimal set of inclusion parameters for deeming patients eligible has not yet been elucidated. This is due to heterogeneity in the study populations, as well differing approaches employed and also divergences in selection criteria between centres. Recent data have suggested that OLT may represent the most efficacious approach in terms of overall and disease-free survival to the management of NET metastatic to the liver when conducted in accordance with the modified Milan criteria. Therefore, a consensus set of selection criteria requires definition to facilitate stringent and fair allocation of deceased-donor organs, as well as consideration for living-donor organs. In the context of classically non-resectable metastatic tumour bulk, multivisceral transplantation with or without the liver may also be indicated, yet experience is very limited. In this review, we discuss the diagnostic work-up of patients in whom the aforementioned transplantation approaches are being considered, critically analyse the published experience and also anticipate future developments in this field, including a discussion of immediate and longer-term research priorities.

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Everolimus

2016

Reactions Weekly

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Use of Everolimus After Multivisceral Transplantation: A Report of Two Cases

Cited by 8 publications

References 14 publications

Consensus recommendations for use of maintenance immunosuppression in solid organ transplantation: Endorsed by the American College of Clinical Pharmacy, American Society of Transplantation, and the International Society for Heart and Lung Transplantation

Consensus recommendations for use of maintenance immunosuppression in solid organ transplantation: Endorsed by the American College of Clinical Pharmacy, American Society of Transplantation, and the International Society for Heart and Lung Transplantation

Liver transplantation and multivisceral transplantation in the management of patients with advanced neuroendocrine tumours

Everolimus

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