Pulsed immunosuppression with everolimus and anti-αβ T-cell receptor: Laryngeal allograft preservation at six months

Samir S. Khariwala, P. Daniel Knott, Olivia Dan, Aleksandra Klimczak, Maria Siemionow, Marshall Strome

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Objectives: Laryngeal transplantation can restore the voice in patients who have undergone laryngectomy. However, the prospect of lifelong immunosuppression is a drawback to this procedure. We present data from a study aimed at minimizing the need for immunosuppression while maintaining graft viability through a novel pulsed-dosing protocol. Methods: Larynges were transplanted from Lewis-brown Norway (RT11+n, F1) rats to Lewis (RT11) recipients. All recipients received 7 days of treatment with everolimus and mouse anti-rat αβT-cell receptor (anti-TCR) monoclonal antibodies beginning the day before transplantation. At 90 days after transplantation, all recipients received a pulse of the same treatment combination for 5 days. From 90 to 180 days after transplantation, the rats received no treatment (group 1, n = 5), 2.5 mg/kg everolimus per day (group 2, n = 5), or 1.0 mg/kg everolimus per day (group 3, n = 5). Results: Histologic analysis of rats that received everolimus as pulse therapy evidenced no signs of rejection, whereas animals that were untreated after 90 days had normal to mild chronic rejection. T-cell reconstitution occurred 65 days after perioperative immunosuppressive treatment, but less rapidly after pulse therapy. Also, peripheral chimerism was generated in all 3 groups. Conclusions: In the rat laryngeal transplantation model, short-term perioperative therapy with everolimus and anti-TCR followed by pulsing is a viable alternative to the concerns associated with continuous, lifelong immunosuppression.

Original languageEnglish (US)
Pages (from-to)74-80
Number of pages7
JournalAnnals of Otology, Rhinology and Laryngology
Issue number1
StatePublished - Jan 2006


  • Everolimus
  • Laryngeal transplant
  • Rat


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