Pediatric utilization of rapamycin for severe cardiac allograft rejection

Background. Rapamycin is a new immunosuppressive agent that has been shown to be effective in the treatment of acute cardiac rejection in the adult population, Methods. This case documents a pediatric patient with ongoing cardiac rejection that did not abate despite treatment with antithymocyte serum (RATS), corticosteroid pulses, and methotrexate in addition to daily prednisone, mycophenolate mofetil, and tacrolimus, Results. Initiation of therapy with rapamycin resulted in a rapid resolution of cardiac rejection and reduction of concomitant immunosuppressive agents and few side effects. Conclusions. This case illustrated the utilization of rapamycin in a pediatric patient with ongoing acute rejection despite several modifications in treatment.