IMMUNOSUPPRESSIVE THERAPY AFTER LUNG TRANSPLANTATION

Abstract

Data from the Registry of the International Society for Heart and
Lung Transplantation (ISHLT) indicated that in 2000-2006 54 proc. patients after lung transplantation received induction therapy. with antilymphocyte antibodies, monoclonal antibody or anti-interleukin-2-receptor monoclonal antibodies. The vast majority of lung transplant recipients receive a triple-drug maintenance regimen including a calcineurin inhibitor, a cell-cycle inhibitor and steroids. Shift from cyclosporin A to tacrolimus has emerged as the first treatment step of refractory acute rejection followed by high-dose steroids or antilymphocyte agents, total lymphoid irradiation or photopheresis. The treatment of chronic rejection remains deceptive and includes varied strategies such as modification of the maintenance regimen, augmentation of the immunosuppression and/or total lymphoid irradiation and photopheresis.