Optimizing the immunosuppressive regimen in heart transplantation

Conversion to Sirolimus as Primary Immunosuppression Attenuates the Progression of Allograft Vasculopathy After Cardiac Transplantation

“…37 Taken together, cumulating evidence suggests a therapeutic strategy that involves reducing the use of CNI, which may reduce the incidence of CAV. 38 Animal studies 39,40 and a recent review of major immunosuppressive trials 41 have suggested that MMF may have a beneficial effect in attenuating the progression of CAV. In our study, the effect of the secondary immunosuppressant (MMF or AZA) was not significant, although patients treated with MMF preferentially had less intimal hyperplasia compared with the AZA treatment group (Figure 3A and 3B).…”

Utility of the Cylex Assay in Cardiac Transplant Recipients

“…7 However, there is variability in the metabolism of immunosuppressive drugs and an individual drug level may not reflect the effects of other concomitant immunosuppressive medications. 3 The Cylex immune assay was said to provide an independent measure of the overall immune status of a patient, offering the possibility to achieve an ideal immunocompromised state, thereby avoiding rejection (inadequately immunosuppressed) and infection (over-immunosuppressed).…”

Mycophenolate Mofetil Dose Reduction for Gastrointestinal Intolerance is Associated With Increased Rates of Rejection in Heart Transplant Patients

“…1 Recipient survival has improved markedly during the past 2 decades, with 1-and 5-year rates approaching 90% and 70%, respectively. 2,3 The success of this intervention is largely attributable to the development of effective immunosuppressive regimens. Maintenance immunosuppressive therapy typically consists of combination treatment with a calcineurin inhibitor, corticosteroids, and an antiproliferative agent.…”