{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:32:45Z","timestamp":1753878765761,"version":"3.41.2"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Literature is limited comparing adverse effects (AEs) of the proliferation signal inhibitors (PSIs) sirolimus (SRL) and everolimus (EVL) in pediatric heart transplant (HTx) recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010center, observational cohort analysis assessing first use of SRL or EVL in pediatric HTx recipients &lt;21\u2009years of age with up to 2\u2009years follow\u2010up between 2009 and 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010seven patients were included, with 52 (59.8%) receiving EVL and 35 (40.2%) receiving SRL. Tacrolimus with PSI was the most common regimen. Intergroup comparison revealed lower baseline estimated glomerular filtration rate (eGFR) and greater increase in eGFR from baseline to 6\u2009months and latest follow\u2010up in SRL cohort compared to EVL cohort. There was greater increase in HDL cholesterol in SRL cohort compared to EVL cohort. Intragroup analysis revealed eGFR and HDL cholesterol increased significantly within SRL cohort, triglycerides and glycosylated hemoglobin increased in EVL cohort, and LDL cholesterol and total cholesterol increased in both cohorts (all <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). There were no differences in hematological indices or rates of aphthous ulcers, effusions, or infections between cohorts. Incidence of proteinuria was not significantly different among those screened within cohorts. Of those included in our analysis, one patient in SRL cohort (2.9%) and two in EVL cohort (3.8%) had PSI withdrawn due to AE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low\u2010dose PSIs in calcineurin inhibitor minimization regimens appear well\u2010tolerated with low withdrawal rate secondary to AE in pediatric HTx recipients. While incidence of most AE was similar between PSI, our results suggest EVL may be associated with less favorable metabolic impact than SRL in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14487","type":"journal-article","created":{"date-parts":[[2023,3,4]],"date-time":"2023-03-04T07:44:16Z","timestamp":1677915856000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of the adverse effects of sirolimus versus everolimus in pediatric heart transplant recipients"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0037-8065","authenticated-orcid":false,"given":"David M.","family":"Newland","sequence":"first","affiliation":[{"name":"Department of Pharmacy Seattle Children's Hospital  Seattle Washington USA"},{"name":"School of Pharmacy University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9106-7558","authenticated-orcid":false,"given":"Beatrice E.","family":"Rosete","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Seattle Children's Hospital  Seattle Washington USA"},{"name":"School of Pharmacy University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4282-4812","authenticated-orcid":false,"given":"Yuk M.","family":"Law","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9484-3006","authenticated-orcid":false,"given":"Mariska S.","family":"Kemna","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3072-4195","authenticated-orcid":false,"given":"Erin L.","family":"Albers","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borah J.","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Humera","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn L.","family":"Spencer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6161-7651","authenticated-orcid":false,"given":"Joshua M.","family":"Friedland\u2010Little","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16977"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.03.111"},{"key":"e_1_2_10_4_1","unstructured":"Zortress\u00ae Package insert. Novartis pharmaceuticals corp;2021."},{"key":"e_1_2_10_5_1","unstructured":"Rapamune\u00ae Package insert. 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