Everolimus for the Prevention of Allograft Rejection and Vasculopathy in Cardiac-Transplant Recipients

This clinical trial compared everolimus, an immunosuppressive and antiproliferative agent, with azathioprine in patients who had undergone cardiac transplantation. Everolimus reduced the incidence of both acute rejection and coronary vasculopathy, a serious disorder that causes deterioration of the graft. A promising agent for management of rejection and vasculopathy. Among recipients of heart transplants, vasculopathy of the allograft is the main cause of illness and death after the first year. 1 , 2 Early immunologic and nonimmunologic endothelial damage may initiate pathologic remodeling, resulting in progressive luminal narrowing. 3 – 5 The development of immunosuppressive agents to prevent acute allograft rejection and the proliferation of smooth-muscle cells may reduce the frequency and severity of vasculopathy. Intravascular ultrasonography is a sensitive approach for the early detection of vasculopathy. 6 – 8 If performed at the same sites at base line and one year after transplantation, ultrasonography can be used to evaluate the progression of intimal proliferation. . . .