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Review
. 2020 Mar;8(6):409.
doi: 10.21037/atm.2019.12.117.

Immunosuppressive strategies in lung transplantation

Paul A Chung  1 , Daniel F Dilling  1
Affiliations
Review

Immunosuppressive strategies in lung transplantation

Paul A Chung et al. Ann Transl Med. 2020 Mar.

Abstract

Lung transplantation is a viable option for those with end-stage lung disease which is evidenced by the continued increase in the number of lung transplantations worldwide. However, patients and clinicians are constantly faced with acute and chronic rejection, infectious complications, drug toxicities, and malignancies throughout the lifetime of the lung transplant recipient. Conventional maintenance immunosuppression therapy consisting of a calcineurin inhibitor (CNI), anti-metabolite, and corticosteroids have become the standard regimen but newer agents and modalities continue to be developed. Here we will review induction agents, maintenance immunosuppressives, adjunctive therapies and other strategies to improve long-term outcomes.

Keywords: Lung transplantation; induction; maintenance; review.

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Conflict of interest statement

Conflicts of Interest: The series “Strategies to Achieve Long-Term Success of Lung Transplantation” was commissioned by the editorial office without any funding or sponsorship. The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Use of induction immunosuppression as a percentage of all adult lung transplantation reported to the International Society of Heart and Lung Transplantation registry database from January 2004 to December 2016. Included patients were those who were on prednisone and alive at discharge post-lung transplantation. ALG/ATG, anti-lymphocyte globulin/anti-thymocyte globulin; IL-2R, interleukin-2 receptor. Reproduced from (2).
Figure 2
Figure 2
Maintenance immunosuppression as a percentage for all adult lung transplantation at 1-year follow-up reported to the International Society of Heart and Lung Transplantation registry database. Each bar represents the one-year follow up from 2004 to 2017. Included patients were those who were on prednisone and were alive at 1-year follow-up. MMF/MPA, mycophenolate mofetil/mycophenolic acid. Reproduced from (2).
See this image and copyright information in PMC

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