Review of immunosuppression for lung transplantation. Novel drugs, new uses for conventional immunosuppressants, and alternative strategies.
The history, pharmacokinetics, mechanisms of action, and experimental as well as clinical data on the immunosuppressive potential of the novel drugs tacrolimus (FK506), sirolimus (rapamycin), mycophenolic acid (mycophenolate mofetil), and leflunomide (and its malononitriloamide analogues) are provided. Novel approaches with the following conventional immunosuppressants are outlined: methotrexate, aerosolized immunosuppression and the implementation of steroid taper. Total lymphoid irradiation and photopheresis for treatment of recurrent rejection are also discussed.
Hausen
B
B
Department of Cardiothoracic Surgery, Transplantation Immunology, Stanford University School of Medicine, California, USA.
Morris
R E
RE
D006084:Graft Rejection / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007555:Isoxazoles / Q000627:therapeutic use; D000077339:Leflunomide; D016040:Lung Transplantation / Q000276:immunology*; D015182:Lymphatic Irradiation; D008727:Methotrexate / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000627:therapeutic use; D017893:Photopheresis; D011090:Polyenes / Q000627:therapeutic use; D012008:Recurrence; D020123:Sirolimus; D016559:Tacrolimus / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D007555:Isoxazoles; D011090:Polyenes; D000077339:Leflunomide; D009173:Mycophenolic Acid; D020123:Sirolimus; D016559:Tacrolimus; D008727:Methotrexate