Heart transplantation immunosuppressive therapy: Difference between revisions
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==Immunosuppressive Therapy== | ==Immunosuppressive Therapy== | ||
=== | Post-transplantation immunosuppressive therapy consists of two stages- Induction and Maintenance. <ref name="ChambersYusen2017">{{cite journal|last1=Chambers|first1=Daniel C.|last2=Yusen|first2=Roger D.|last3=Cherikh|first3=Wida S.|last4=Goldfarb|first4=Samuel B.|last5=Kucheryavaya|first5=Anna Y.|last6=Khusch|first6=Kiran|last7=Levvey|first7=Bronwyn J.|last8=Lund|first8=Lars H.|last9=Meiser|first9=Bruno|last10=Rossano|first10=Joseph W.|last11=Stehlik|first11=Josef|title=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|journal=The Journal of Heart and Lung Transplantation|volume=36|issue=10|year=2017|pages=1047–1059|issn=10532498|doi=10.1016/j.healun.2017.07.016}}</ref> | ||
=== | Even though regimens vary from center to center and case to case, most regimens consist of 2-3 drugs, usually including- <ref>{{cite journal|doi=10.1016/j.healun.2017.07.019.}}</ref> <ref name="SöderlundRådegran2015">{{cite journal|last1=Söderlund|first1=Carl|last2=Rådegran|first2=Göran|title=Immunosuppressive therapies after heart transplantation — The balance between under- and over-immunosuppression|journal=Transplantation Reviews|volume=29|issue=3|year=2015|pages=181–189|issn=0955470X|doi=10.1016/j.trre.2015.02.005}}</ref> | ||
*'''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== | ==References== | ||
Revision as of 13:04, 7 June 2020
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Heart transplantation immunosuppressive therapy On the Web |
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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.