[Immunosuppression after heart and lung transplantation]

In the last two decades heart and lung transplantation have evolved to an accepted treatment of endstage heart and lung failure. A differentiated immuno-suppressive regimen is the long term basis of successful transplantation and must be adopted to the individual patient. Rejection and immunosuppression with potential side effects must be balanced to achieve optimal outcome in each patient. In the long-term follow up an efficient diagnosis and treatment of rejection probably also results in reduction of chronic organ failure and improvement of general postoperative results. In cases of vasculopathy after heart transplantation or obliterative bronchiolitis after lung transplantation alternative immunosuppressive drugs are options in the medical therapy. We present our postoperative management protocol after heart and lung transplantation. Potential problems, new immunosuppressive options and side-effects of immunosuppression are discussed.