Everolimus in different combinations as maintenance immunosuppressive therapy in heart transplant recipients

OBJECTIVES: We examined the experiences of heart transplant recipients receiving everolimus as maintenance therapy in different combinations over a long time. MATERIALS AND METHODS: Between 2004 and 2009, forty patients (29 men, 11 women; mean age, 51.6 y) were switched from a routine immunosuppressive regimen to everolimus. Indications were other (2), renal insufficiency (17), cardiac allograft vasculopathy (14), and ongoing cellular rejection (7). Combinations were either along with cyclosporine (24), mycophenolate mofetil (14), or others (2). Indications for the introduction of everolimus including safety, efficacy, different combinations of everolimus, biopsy-proven acute rejections, renal function, and infections were evaluated retrospectively. RESULTS: Five patients died, 4 of them were still on everolimus at the time of death; they died from intracerebral hemorrhage (1), embolism (1), cardiac arrest (2), and unknown (1). Everolimus was discontinued in 6 patients owing to severe adverse effects: Edema (2), gastrointestinal adverse effects (3), and dermal adverse effects (1). Mean everolimus trough levels were 5.8 μmol/L at 6 months and 4.9 at 60 months. Mean cyclosporine levels were 67.62 μmol/L at 6 months and 47.3 μmol/L at 60 months. Mean serum creatinine levels were stable (147.9 μmol/L after 60 months). Four life-threatening infections (all pneumonia) occurred but resulted in complete recovery. CONCLUSIONS: Everolimus is safe with different immunosuppressive combinations after receiving a heart transplant

Rucio: Scientific data management

Rucio is an open-source software framework that provides scientific collaborations with the functionality to organize, manage, and access their data at scale. The data can be distributed across heterogeneous data centers at widely distributed locations. Rucio was originally developed to meet the requirements of the high-energy physics experiment ATLAS, and now is continuously extended to support the LHC experiments and other diverse scientific communities. In this article, we detail the fundamental concepts of Rucio, describe the architecture along with implementation details, and give operational experience from production usage.Facultad de Informátic