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. 2018 Sep;5(3):212-219.
doi: 10.1007/s40472-018-0199-4. Epub 2018 Jul 13.

Immunosuppression for Lung Transplantation: Current and Future

Satish Chandrashekaran  1 , Stacy A Crow Pharm  2   3 , Sadia Z Shah  4 , Chris J Arendt Pharm  2   3 , Cassie C Kennedy  3   5
Affiliations

Immunosuppression for Lung Transplantation: Current and Future

Satish Chandrashekaran et al. Curr Transplant Rep. 2018 Sep.

Abstract

Purpose of the review: The number of lung transplantations performed worldwide continues to increase. There is a growing need in these patients for more effective immunosuppressive medications with less toxicity.

Recent findings: This review article summarizes the recent studies and developments in lung transplant immunosuppression. Novel immunosuppressive medications and strategies used in other solid organ transplantations are being trialed in lung transplantation. This includes the use of co-stimulation blockers like belatacept and mTOR inhibitors like everolimus. Calcineurin sparing regimens have been described in an attempt to minimize nephrotoxicity. Assays to measure the bioactivity of immunosuppressive medications to determine the global immune competence, such as Immuknow assay and Gamma interferon response are gaining traction.

Summary: Immunosuppression in lung transplant is evolving with the development of newer drugs and promising strategies to optimize immunosuppression. Further studies with multicenter randomized trials are required to increase the strength of the evidence.

Keywords: Lung transplantation; calcineurin-sparing regimens; global immune competence; immunosuppression.

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Conflict of interest statement

Conflict of Interest Satish Chandrashekaran, Stacy A. Crow, Sadia Z. Shah, Chris J. Arendt, and Cassie Kennedy declare no conflict of interest.

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