Immunosuppressive therapies after heart transplantation — The balance between under- and over-immunosuppression

摘要: Since the first heart transplantation (HT) in 1967, survival has steadily improved. Issues related to over- and under-immunosuppression are, however, still common following HT. Whereas may result rejection, over-immunosuppression render other medical problems, including infections, malignancies chronic kidney disease (CKD). As such complications constitute major limiting factors for long-term HT, identifying improved diagnostic preventive methods been focus of many studies. Notably, research on antibody-mediated rejection (AMR) cardiac allograft vasculopathy (CAV) recently led development nomenclatures that aid their diagnosis treatment. Moreover, novel immunosuppressants (such as mammalian target rapamycin [m-TOR] inhibitors) strategies aimed at minimizing use calcineurin inhibitors (CNIs) corticosteroids (CSs), have provided alternatives traditional combination maintenance immunosuppressive therapy CSs, cyclosporine (CSA) or tacrolimus (TAC), azathioprine (AZA) mycophenolate mofetil (MMF). Research within this field medicine is not only extensive, but also constant progress. The purpose present review was therefore summarize some points regarding therapies after HT balance between under- over-immunosuppression. Transplant immunology, problems over-immunosuppression, well induction drugs therapies, are addressed.