Heart transplantation immunosuppressive therapy
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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D.; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [1]
Immunosuppressive Therapy
Post-transplantation immunosuppressive therapy consists of two stages- Induction and Maintenance. [1]
Even though regimens vary from center to center and case to case, most regimens consist of 2-3 drugs, usually including- [2] [3]
- Calcineurin inhibitor- Tacrolimus or Cyclosporin
- Anti-metabolite- Mycophenolate mofetil, Azathioprine
- Glucocorticoids- tapering dose
- Mammalian target of rapamycin [m-TOR] inhibitors and other strategies are aimed at minimizing the use of calcineurin inhibitors and corticosteroids.
- Proliferation signal inhibitors (sirolimus and everolimus)- In case of cardiac allograft vasculopathy (CAV) or renal insufficiency
References
- ↑ Chambers, Daniel C.; Yusen, Roger D.; Cherikh, Wida S.; Goldfarb, Samuel B.; Kucheryavaya, Anna Y.; Khusch, Kiran; Levvey, Bronwyn J.; Lund, Lars H.; Meiser, Bruno; Rossano, Joseph W.; Stehlik, Josef (2017). "The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Lung And Heart-Lung Transplantation Report—2017; Focus Theme: Allograft ischemic time". The Journal of Heart and Lung Transplantation. 36 (10): 1047–1059. doi:10.1016/j.healun.2017.07.016. ISSN 1053-2498.
- ↑ . doi:10.1016/j.healun.2017.07.019. Check
|doi=value (help). Missing or empty|title=(help) - ↑ Söderlund, Carl; Rådegran, Göran (2015). "Immunosuppressive therapies after heart transplantation — The balance between under- and over-immunosuppression". Transplantation Reviews. 29 (3): 181–189. doi:10.1016/j.trre.2015.02.005. ISSN 0955-470X.