{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:13:27Z","timestamp":1790144007271,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,6,8]],"date-time":"2017-06-08T00:00:00Z","timestamp":1496880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Everolimus reduces the incidence of cardiac\u2010allograft vasculopathy (<jats:styled-content style=\"fixed-case\">CAV<\/jats:styled-content>) and is less renally toxic than are calcineurin inhibitors (<jats:styled-content style=\"fixed-case\">CNI<\/jats:styled-content>s). We evaluated the safety of <jats:styled-content style=\"fixed-case\">CNI<\/jats:styled-content>\u2010free everolimus for post\u2010heart transplant (<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the records of 36 consecutive patients who had undergone an <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x between January 2006 and December 2013 in National Cheng Kung University Hospital. All patients initially had been treated with the standard tacrolimus regimen. The Study group\u201412 patients with <jats:styled-content style=\"fixed-case\">CAV<\/jats:styled-content>, renal impairment, or a history of malignancy\u2014were switched from tacrolimus to everolimus. The Control group consisted of 19 patients who remained on the standard regimen. The target everolimus trough concentration was 8\u201014\u00a0ng\/mL. The primary outcome was survival, and the secondary outcomes were bacterial, viral, fungal, and other infections; <jats:italic>Pneumocystis jirovecii<\/jats:italic> pneumonia (<jats:styled-content style=\"fixed-case\">PJP<\/jats:styled-content>); and rejection (\u22652R).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a 53.3\u00b125.6\u2010month follow\u2010up, the survival rate, rejection rate, and number of infections, except for <jats:styled-content style=\"fixed-case\">PJP<\/jats:styled-content>, were not significantly different between the two groups. In the Study group, 6 patients were diagnosed with <jats:styled-content style=\"fixed-case\">PJP<\/jats:styled-content> 33\u00b118.2\u00a0months after switching. None of the Control group patients were diagnosed with <jats:styled-content style=\"fixed-case\">PJP<\/jats:styled-content> during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A high\u2010dose <jats:styled-content style=\"fixed-case\">CNI<\/jats:styled-content>\u2010free everolimus maintenance regimen might yield a higher incidence of post\u2010transplantation <jats:styled-content style=\"fixed-case\">PJP<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12709","type":"journal-article","created":{"date-parts":[[2017,4,20]],"date-time":"2017-04-20T07:46:55Z","timestamp":1492674415000},"source":"Crossref","is-referenced-by-count":8,"title":["High\u2010dose calcineurin inhibitor\u2010free everolimus as a maintenance regimen for heart transplantation may be a risk factor for <i><scp>P<\/scp>neumocystis<\/i> pneumonia"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2938-4100","authenticated-orcid":false,"given":"Yu\u2010Ning","family":"Hu","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery Department of Surgery National Cheng Kung University Hospital College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan\u2010Yao","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Infection Department of Internal Medicine College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun\u2010Neng","family":"Roan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Department of Surgery National Cheng Kung University Hospital College of Medicine National Cheng Kung University  Tainan Taiwan"},{"name":"Institute of Clinical Medicine National Cheng Kung University Hospital and College of Medicine  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010Hsin","family":"Hsu","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine National Cheng Kung University Hospital and College of Medicine  Tainan Taiwan"},{"name":"Division of Critical Care Medicine Department of Internal Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University  Tainan Taiwan"},{"name":"Division of Cardiology Department of Internal Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chwan\u2010Yau","family":"Luo","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Department of Surgery National Cheng Kung University Hospital College of Medicine National Cheng Kung University  Tainan Taiwan"},{"name":"Cardiovascular Research Center National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022171"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.54.222"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.08.014"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2010.511611"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/339548"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/322733"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyt019"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmcr.2013.07.003"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.05.034"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02914.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.12659\/AOT.883812"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2013.06.001"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.11.036"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.09.014"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.07.060"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2013.03.002"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.01.017"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.12.062"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31821774bd"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.09.031"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.01.005"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1600-6143.2004.00601.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2012.01.094"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.03.002"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2012.00740.x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000280546.91617.6c"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.49.9277"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2010.03143.x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181aad256"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e31829d5017"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e31817a7e30"}],"container-title":["Transplant 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