Immunosuppression and adult heart transplantation: emerging therapies and opportunities

Abstract

Immunosuppression following heart transplantation has improved graft longevity through the reduction of cellular and antibody mediated rejection. The attempt to limit the unintended consequences of immunosuppressive therapies and address sensitized patients has led to a revolution in immunosuppression. Areas covered: This review will focus on the current emerging immunosuppressive therapies in heart transplantation while reviewing the effective contemporary treatments, and explore the potential development of new immunomodulatory therapies. An exhaustive review of the PubMed database and abstract data from national meetings was performed to compile the data for the manuscript. Expert commentary: The timing and targets of immunosuppressive therapies are evolving to provide adjunctive therapies to the established treatments. Recent advances will allow for further tailoring of immunomodulatory therapies to the individual patient.

Keywords: Heart transplantation; antibody mediated rejection; cardiac allograft vasculopathy; cellular rejection; immunosuppression.