Efficacy and safety of everolimus in heart transplant recipients: A meta-analysis

Vitte SH, Luna AM, Pille JJ, Pinheiro BN, Souza MBL, Irudhayaraj CDJ, Munaretto GM · 2026 · JHLT Open · Atlas ID VITTE2026

What this study shows

Meta-analysis of 60 studies (1786 heart transplant recipients): everolimus-based immunosuppression reduced cardiac allograft vasculopathy progression on IVUS (RR ~0.57) and preserved renal function (eGFR +10-15 mL/min) when combined with calcineurin-inhibitor minimisation, with neutral all-cause mortality (RR ~0.98) but more adverse events and treatment discontinuation.

Abstract

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Long-term outcomes after heart transplantation remain limited by cardiac allograft vasculopathy (CAV) and calcineurin inhibitor (CNI)-related nephrotoxicity. Everolimus has emerged as a CNI-sparing strategy, yet its net clinical benefit remains debated. To determine whether everolimus-based immunosuppression improves efficacy and safety compared with standard CNI-based therapy in heart transplant recipients. We conducted a systematic review and meta-analysis of randomized controlled trials and comparative observational studies enrolling adult and/or pediatric heart transplant recipients.

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At a glance

Evidence type	S Synthesis of human data Marked S because it synthesizes multiple human studies (a systematic review or meta-analysis); the code names the kind of study, not the quality of any single included study.
Study type	1 - Systematic Review
Model system	Human (adult and paediatric heart transplant recipients)
Journal	JHLT Open
Year	2026
Peer reviewed	Yes
Record last updated	2026-08-22
Source	DOI 10.1016/j.jhlto.2026.100610 · PMID 42656203 · Free full text (PMC13506258)

Extracted findings

Intervention	Everolimus-based immunosuppression (with calcineurin-inhibitor minimisation or withdrawal) vs standard CNI-based therapy
Target	mTORC1 (everolimus)
Model	Human
Effect	Reduced cardiac allograft vasculopathy progression and better renal function; mortality neutral; more adverse events and discontinuations

Cite this paper

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Vitte, S. H., Luna, A. M., Pille, J. J., Pinheiro, B. N., Souza, M. B. L., Irudhayaraj, C. D. J., & Munaretto, G. M. (2026). Efficacy and safety of everolimus in heart transplant recipients: A meta-analysis. JHLT Open. https://doi.org/10.1016/j.jhlto.2026.100610

@article{VITTE2026,
  author       = {Vitte, S. H. and Luna, A. M. and Pille, J. J. and Pinheiro, B. N. and Souza, M. B. L. and Irudhayaraj, C. D. J. and Munaretto, G. M.},
  title        = {{Efficacy and safety of everolimus in heart transplant recipients: A meta-analysis}},
  journal      = {JHLT Open},
  year         = {2026},
  doi          = {10.1016/j.jhlto.2026.100610},
  note         = {PMID: 42656203},
}

Cite this Atlas record

The record is the Atlas's own work — the evidence label, the extracted findings and the links. It is cited as part of the dataset, not as the paper.

Barton, O. (2026). Oliver's mTOR Atlas (record VITTE2026) [Data set]. https://mtor-atlas.org/study/VITTE2026/ · Dataset DOI 10.5281/zenodo.22059963

@misc{atlas_VITTE2026,
  author       = {Barton, Oliver},
  title        = {{Oliver's mTOR Atlas}, record VITTE2026},
  howpublished = {Data set},
  year         = {2026},
  url          = {https://mtor-atlas.org/study/VITTE2026/},
  doi          = {10.5281/zenodo.22059963}
}