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Impact of Everolimus Initiation and Corticosteroid Weaning During Acute Phase After Heart Transplantation on Clinical Outcome: Data from the Korean Organ Transplant Registry (KOTRY)

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Author(s)
Kyu-Sun LeeHyungseop KimSun Hwa LeeDong-Ju ChoiMinjae YoonEun-Seok JeonJin-Oh ChoiJeehoon KangHae-Young LeeSung-Ho JungJaewon OhSeok-Min KangSoo Yong LeeMin Ho JuJae-Joong KimMyoung Soo KimHyun-Jai Cho
Keimyung Author(s)
Kim, Hyung SeopLee, Seon hwa
Department
Dept. of Internal Medicine (내과학)
Journal Title
Transpl Int
Issued Date
2024
Volume
37
Keyword
Korean Organ Transplant Registrycardiac allograft vasculopathyheart transplantationmTOR inhibitorprimary outcomerejectionsteroid weaning
Abstract
The effect of changes in immunosuppressive therapy during the acute phase post-heart transplantation (HTx) on clinical outcomes remains unclear. This study aimed to investigate the effects of changes in immunosuppressive therapy by corticosteroid (CS) weaning and everolimus (EVR) initiation during the first year post-HTx on clinical outcomes. We analyzed 622 recipients registered in the Korean Organ Transplant Registry (KOTRY) between January 2014 and December 2021. The median age at HTx was 56 years (interquartile range [IQR], 45-62), and the median follow-up time was 3.9 years (IQR 2.0-5.1). The early EVR initiation within the first year post-HTx and maintenance during the follow-up is associated with reduced the risk of primary composite outcome (all-cause mortality or re-transplantation) (HR, 0.24; 95% CI 0.09-0.68; p < 0.001) and cardiac allograft vasculopathy (CAV) (HR, 0.39; 95% CI 0.19-0.79; p = 0.009) compared with EVR-free or EVR intermittent treatment regimen, regardless of CS weaning. However, the early EVR initiation tends to increase the risk of acute allograft rejection compared with EVR-free or EVR intermittent treatment.
Keimyung Author(s)(Kor)
김형섭
이선화
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1432-2277
Source
https://www.frontierspartnerships.org/articles/10.3389/ti.2024.11878/full
DOI
10.3389/ti.2024.11878
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45588
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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