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Immunosupressive therapy in the lung transplant recipient

Gordana Pavliša
Andrea Vukić Dugac
Peter Jaksch
Miroslav Samaržija

Sažetak

Lung transplantation has become a life-saving procedure for individuals with variety of end-stage respiratory diseases. Optimal immunosuppression remains the key to long-term graft survivival. The protocols for immunosuppressive therapy following lung transplantation can be divided into three general categories: induction, maintenance, and treatment of rejection. The goal of induction therapy is to provide intense immunosuppression in the early post-transplantation period, when the risk of allograft rejection is the highest. Induction agents primarily target T lymphocytes, which are considered the effector cells in cell-mediated rejection. Current maintenance therapy typically includes a calcineurin inhibitor, nucleotide blocking agent and corticosteroid. Pulse steroids are generally the first treatment of acute cellular rejection. Therapeutic modalities for treatment of refractory cellular rejection include switch from cyclosporine to tacrolimus, use of lymphocyte depleting agents, azithromycine, and extracorporeal photopheresis. Treatment options for humoral rejections include plasmapheresis and immunoglobulines in combination with rituximab.

Ključne riječi

lung transplantation; immunosuppression; induction therapy; maintenance therapy; rejection

Hrčak ID:

139007

URI

https://hrcak.srce.hr/139007

Datum izdavanja:

14.5.2015.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.176 *