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Related Experiment Videos

Immunosuppression: evolution in practice and trends, 1993-2003.

Ron Shapiro1, James B Young, Edgar L Milford

  • 1Thomas E. Starzl Transplant, University of Pittsburgh, Pittsburgh, PA, USA. shapiror@msx.upmc.edu

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|March 12, 2005
PubMed
Summary
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Immunosuppression in organ transplantation has evolved, with shifts in antibody induction and maintenance therapies like calcineurin inhibitors and antimetabolites. Steroid avoidance protocols are also beginning to impact immunosuppressive strategies across various organ transplants.

Area of Science:

  • Immunology
  • Transplantation Medicine
  • Pharmacology

Background:

  • The past decade has seen significant changes in immunosuppression for solid organ transplantation.
  • The Food and Drug Administration (FDA) approved new medications, broadening treatment options.

Purpose of the Study:

  • To analyze organ-specific trends in immunosuppressive drug use over the last ten years.
  • To identify shifts in antibody induction, maintenance immunosuppression, and steroid use.

Main Methods:

  • Review of Scientific Registry of Transplant Recipients (SRTR) data.
  • Organ-by-organ analysis of immunosuppression trends.

Main Results:

  • Antibody induction is common in kidney, pancreas, and intestine transplants but less so in liver and thoracic organs.

Related Experiment Videos

  • A shift occurred from older antibody preparations (muromonab-CD3, horse ATG) to rabbit ATG and anti-IL-2 receptor antagonists.
  • Maintenance immunosuppression shows a trend from cyclosporine to tacrolimus and from azathioprine to mycophenolate mofetil.
  • Steroid avoidance protocols are showing a slight decrease in corticosteroid use across organs.

    • Conclusions:

    • Significant evolution in immunosuppressive drug choices for solid organ transplantation has occurred.
    • Current trends reflect a move towards more targeted therapies and reduced steroid use.