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Immunsuppression nach Herz- und Lungentransplantation

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Immunosuppression after heart and lung transplantation

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Der Nephrologe Aims and scope

Zusammenfassung

Die immunsuppressive Langzeittherapie nach Herz- und Lungentransplantationen basiert auf vier verschiedenen Gruppen an Immunsuppressiva: Calcineurininhibitoren (Ciclosporin oder Tacrolimus), Antimetaboliten (Azathioprin oder Mycophenolatmofetil), mTOR („mammalian target of rapamycin“)-Inhibitoren (Sirolimus oder Everolimus) und Kortikosteroiden. Die Mehrheit der Patienten nach Herz- oder Lungentransplantation erhalten eine Dreifachbehandlung, die aus einem Calcineurininhibitor, einem Antimetaboliten und Kortikosteroiden zusammengesetzt ist. In einigen Zentren wird zusätzlich eine Induktionstherapie verabreicht, die aus einer kurzen perioperativen Gabe von mono- oder polyklonalen Antikörpern besteht.

Abstract

Immunosuppression after heart and lung transplantation is generally based on four groups of immunosuppressive agents: calcineurin inhibitors (cyclosporin A or tacrolimus), antimetabolites (azathioprine or mycophenolate mofetil), mammalian target of rapamycin inhibitors (rapamycin or everolimus), and corticosteroids. Most patients after heart or lung transplantation are treated with a triple immunosuppressive regimen, consisting of a calcineurin inhibitor, an antimetabolite, and corticosteroids. In addition, some centers use induction therapy, consisting of the perioperative application of intravenous mono- or polyclonal antibodies, targeting activated host lymphocytes.

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  1. Herzchirurgischen Klinik und Poliklinik, Klinikum der Universität München/Großhadern, Marchioninistr. 15, 81377, München, Deutschland

    D. Schmauss &  B. Meiser

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  1. D. Schmauss
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  2. B. Meiser
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Correspondence to B. Meiser.

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Schmauss, D., Meiser, B. Immunsuppression nach Herz- und Lungentransplantation. Nephrologe 5, 126–132 (2010). https://doi.org/10.1007/s11560-009-0372-y

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