The role of induction therapy in lung transplantation

Induction immunosuppression in solid organ transplantation involves a short course of potent immunosuppression in the perioperative period, with the goal of preventing early acute rejection and delaying initiation or reducing the dose of calcineurin inhibitors to minimize kidney injury. The use of induction immunosuppression in lung transplantation has increased over time, with over 80% of adult lung transplant recipients receiving some form of induction therapy. Currently, more than 70% of lung transplant recipients receive induction with an interleukin-2 receptor antagonist, and basiliximab is the most used agent. Despite this now common practice, the evidence to support and guide induction immunosuppression following lung transplantation is limited, making the use of induction somewhat controversial. Here, we review the available literature addressing the use of induction immunosuppression in lung transplant recipients.