{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:53:26Z","timestamp":1789178006976,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,3]],"date-time":"2024-03-03T00:00:00Z","timestamp":1709424000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Immunosuppression after heart transplantation (HTX) with mammalian target of rapamycin (mTOR) inhibitors serves as a prophylaxis against rejection and to treat coronary vascular injury. However, there is little data on the early, preventive use of everolimus after pediatric HTX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective study of 61 pediatric HTX patients (48 cardiomyopathy and 13 congenital heart disease), 28 females, median age 10.1 (range 0.1\u201317.9) years transplanted between 2008 and 2020. We analyzed survival, rejection, renal function, occurrence of lymphoproliferative disorder, and allograft vasculopathy together with adverse effects of early everolimus therapy combined with low\u2010dose calcineurin inhibitors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Everolimus therapy was started at a median 3.9 (1\u201314) days after HTX. Median follow\u2010up was 4.3 (range 0.5\u201311.8) years, cumulative 184 patient years. The estimated 1\u2010 and 5\u2010year survival probability was 89% (CI 82%:98%) and 87% (CI 78%:97%). Four patients developed rejection (6.6%) (maximum 2R ISHLT criteria). No patient suffered from chronic renal failure. Three patients (4.9%) developed post\u2010transplant lymphoproliferative disorder. Five patients suffered relevant wound\u2010healing disorders after transplantation, four of them carrying relevant risk factors before HTX (mechanical circulatory support (n\u2009=\u20093), delayed chest closure after HTX (n\u2009=\u20093)). No recipient developed cardiac allograft vasculopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Initiating everolimus within the first 14\u2009days after HTX seems to be well tolerated, enabling a low incidence of rejection, post\u2010transplant lymphoproliferative disorders, renal failure, and reveals no evidence of cardiac allograft vasculopathy as well as good overall survival in pediatric heart transplant recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14698","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T04:53:51Z","timestamp":1709528031000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["<scp>mTor<\/scp>\u2010inhibition within the first days after pediatric heart transplantation is a potentially safe option to prevent cardiac allograft vasculopathy"],"prefix":"10.1111","volume":"28","author":[{"given":"Hannah","family":"Kreienbaum","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, Faculty of Medicine, University Heart Center Freiburg \u2013 Bad Krozingen, Medical Center \u2013 University of Freiburg University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7657-4647","authenticated-orcid":false,"given":"Brigitte","family":"Stiller","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, Faculty of Medicine, University Heart Center Freiburg \u2013 Bad Krozingen, Medical Center \u2013 University of Freiburg University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rouven","family":"Kubicki","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, Faculty of Medicine, University Heart Center Freiburg \u2013 Bad Krozingen, Medical Center \u2013 University of Freiburg University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexej","family":"Bobrowski","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, Faculty of Medicine, University Heart Center Freiburg \u2013 Bad Krozingen, Medical Center \u2013 University of Freiburg University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kroll","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, University Heart Center Freiburg \u2013 Bad Krozingen, Medical Center \u2013 University of Freiburg University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4531-5930","authenticated-orcid":false,"given":"Thilo","family":"Fleck","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, Faculty of Medicine, University Heart Center Freiburg \u2013 Bad Krozingen, Medical Center \u2013 University of Freiburg University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.08.002"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(06)68969\u20101"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000150332.42276.69"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000070421.38604.2B"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2020.01.825"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6904-12-2"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00365.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.01.1204"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2005.03.019"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13072"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.05.016"},{"key":"e_1_2_9_13_1","unstructured":"ColvinM SmithJM HadleyN et\u00a0al.OPTN\/SRTR 2018 Annual Data Report: Heart. 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