Key result
Switching everolimus to mycophenolate mofetil resolves severe hypertriglyceridemia peaking at 4960 mg/dL in a transplant patient.
Why the study?
mTOR inhibitors such as everolimus are used post-transplant to reduce calcineurin inhibitor nephrotoxicity, but they can induce severe dyslipidemia including marked hypertriglyceridemia with pancreatitis risk.
Everolimus can cause severe hypertriglyceridemia in lung transplant recipients, necessitating close lipid monitoring and prompt adjustment of immunosuppressive therapy.
Answers are grounded in this paper and cite their sources.
Warrants close lipid monitoring with prompt regimen adjustment in everolimus-treated lung transplant patients; hypothesis-generating for severe reversible hypertriglyceridemia.
Introduction -mTOR inhibitors (e.g., everolimus) are increasingly used post-transplant to reduce calcineurin inhibitor nephrotoxicity but can cause severe dyslipidemia, including marked hypertriglyceridemia with pancreatitis risk.[1] Case presentation -A 64-year-old man with type 2 diabetes, chronic obstructive pulmonary disease (COPD) with pleiomorphic giant-cell carcinoma resected underwent left single-lung transplantation in March 2023.Everolimus was introduced on April 9, 2025 to spare calcineurin inhibitors in the setting of worsening renal function requiring dialysis.Triglycerides rose from 256 mg/dL (March 24, 2022) to 2886 mg/dL (August 5, 2025) and 4960 mg/dL (September 16, 2025).Everolimus was replaced by mycophenolate mofetil on September 26, 2025, with TG falling to 2000 mg/dL (September 29, 2025) and 300 mg/dL (November 3, 2025).Interventions -Discontinuation of everolimus and switch to mycophenolate mofetil; continuation of pravastatin; dietary measures.Outcomes -Rapid triglycerides reduction after stopping everolimus; no acute pancreatitis documented in the available data.Conclusion -This case highlights everolimus-associated hypertriglyceridemia in a lung transplant recipient and underscores the need for tight lipid monitoring and early immunosuppression adjustment when severe dyslipidemia emerges.
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Tournayre et al. (2026) studied this question. Everolimus caused severe hypertriglyceridemia peaking at 4960 mg/dL in a lung transplant patient, which rapidly resolved to 300 mg/dL after switching to mycophenolate mofetil.
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