Early Mammalian Target of Rapamycin Inhibitor Utilization After Heart Transplantation: Analysis of the UNOS Database

PurposeThe clinical characteristics of mammalian target rapamycin (mTOR) inhibitors use in heart transplant (HT) recipients and their outcomes have not been well described.MethodsWe compared patients that received mTOR within the first 2 years after HT to did by inquiring United Network for Organ Sharing database between 2010-2018. The primary endpoint was all-cause mortality with re-transplantation as a competing event. Rejection, malignancy, hospitalization infection renal transplantation were secondary endpoints.ResultsThere 1,619 (9%) 15,686 (81%) mTOR+ mTOR- respectively. Body mass index, induction, cardiac allograft vasculopathy, calculated panel reactive antibody less days 1A status independently associated status. Over follow up 10.4 there no difference adjusting donor recipient (adjusted sub distribution hazard ratio 1.03, [0.90-1.19], p=0.66) (Figure). increased risk rejection (odds 1.43, [1.11-1.83], p=0.005) but infection, or transplantation.ConclusionmTOR are used <10% non-inferior contemporary immunosuppression regimens terms mortality, transplantation. They rejection. described. We endpoints. There