Arquivos Brasileiros de Cardiologia (Feb 2000)

Treatment of persistent rejection with methotrexate in stable patients submitted to heart transplantation

  • Fernando Bacal,
  • Viviane Cordeiro Veiga,
  • Alfredo Inácio Fiorelli,
  • Giovanni Bellotti,
  • Edimar Alcides Bocchi,
  • Noedir Antonio Groppo Stolf,
  • José Antonio Franchini Ramires

DOI
https://doi.org/10.1590/s0066-782x2000000200004
Journal volume & issue
Vol. 74, no. 2
pp. 145 – 148

Abstract

Read online

OBJECTIVE:To evaluate the use of methotrexate for the treatment of recurrent rejection in heart transplant recipients. METHODS: We studied 6 patients submitted to heart transplantation that showed rejection grade > or = 3A (ISHLT) in two consecutives endomyocardial biopsy specimens. The dose was 11.26±3.75mg/week. The evaluated data were: ventricular function, endomyocardial biopsy, white cell count and number of rejection episodes before and after methotrexate administration. RESULTS: There was a reduction in the number of rejection episodes (5.17±1.47 before methotrexate; 2.33±1.75 after 6 months and 3.17±2.99 after 12 months of treatment, p=0.0193). The ventricular function was normal with ejection fraction of 76.5±4.80 before and 75.6±4.59 after methotrexate (p=0.4859). One patient did not finish the treatment because he showed signs of rejection associated with severe pericardial effusion. Five patients had a reduction in the white cell count (8,108±23.72 before and 5650±1350 after methotrexate, p=0.0961). One pulmonary infection with complete resolution after antibiotic treatment was observed. CONCLUSION: Methotrexate in low doses is an effective adjunct therapy in the treatment of recurrent rejection after heart transplantation.

Keywords