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The First Year Post–Heart Transplantation: Use of Immunosuppressive Drugs and Early Complications

Division of Cardiology, University of Texas Medical Branch, Galveston

Ramanna Merla, MD

Division of Cardiology, University of Texas Medical Branch, Galveston

Scott D. Lick, MD

Department of Cardiothoracic Surgery and Transplantation, Universty of Texas Medical Branch, Galveston

Serena M. Aunon, MD

Division of General Internal Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston

Melissa Taylor, PA

Department of Cardiothoracic Surgery and Transplantation, Universty of Texas Medical Branch, Galveston

Melissa Manson, PharmD

Department of Cardiothoracic Surgery and Transplantation, Universty of Texas Medical Branch, Galveston

Lawrence S.C. Czer, MD, FACC

Division of Cardiology, Cedars Sinai Medical Center, Los Angeles, California

Ernst R. Schwarz, MD, PhD, FACC

Division of Cardiology, Cedars Sinai Medical Center, Los Angeles, California,ernst.schwarz{at}cshs.org

A large number of heart transplants are performed annually in different transplant centers in the United States. This is partly because of the improved survival of patients who undergo cardiac transplantation, thus making it a more viable option in the management of end-stage heart failure. The survival benefit after heart transplantation is a result of newer immunosuppressive drug regimens and a better understanding of their effects and interactions. Several studies, mostly involving a small number of patients, describe use and comparison of the many distinct immunosuppressive drugs available to date. Interestingly, many transplant centers perform in-house typical induction treatment regimens because of their own experience and intra-institutional preference. This review summarizes current practices of immunosuppressive drug therapy in the first year post–heart transplant based on the available clinical evidence and discusses future options of heart transplant immunosuppressive drug therapies.

Key Words: drugs • immune suppression • heart transplantation • rejection

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