Immunosuppressive Drugs in Heart Transplantation

Congestive heart failure affects 23 million people worldwide [1]. Cardiac transplantation provides a lifesaving treatment for patients with end-stage heart disease. It offers a longer life with a higher quality to those who have no other treatment alternative. Although cardiac transplantation offers a relief from heart immunosuppression. The goal of immunosuppression immediately following surgery is to prevent hyperacute and acute rejections. Transplantation immunosuppression must be balanced in order to prevent rejection while minimizing the serious adverse effects of therapy including life-threatening infections and malignancies. Immunosuppressive regimens are classified as induction, maintenance, or anti-rejection regimens. Induction regimens consist of intense early post-operative immunosuppression while maintenance regimens are used indefinitely for prevention of acute and chronic rejection. This chapter will review the induction and maintenance immunosuppressive regimens used in heart transplantation with summaries of selected literature as well as the most common complications of these therapies and significant drug-drug interactions.

Keywords: Heart transplantation, Immunosuppression, Interactions, Pharmacotherapy.