Related Experiment Video
Updated: Sep 12, 2025
08:38
Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
17.0K
Monotherapy Immunosuppression in Pediatric Heart Transplant Recipients
Elizabeth L Profita1, Joanne Lee2, Donna Lee2
1Department of Pediatrics (Cardiology), Stanford University, Palo Alto, California, USA.
Pediatric Transplantation
|August 5, 2025
Summary
Pediatric heart transplant patients on single-drug immunosuppression (monotherapy) showed no increased rejection risk. This approach may be suitable for select patients experiencing over-immunosuppression, improving outcomes.
Area of Science:
- Pediatric Cardiology
- Transplantation Immunology
- Immunosuppression Therapy
Background:
- Standard immunosuppression after pediatric heart transplant (HT) involves dual drugs.
- Single-drug immunosuppression (monotherapy) may be an option for select patients.
- This study evaluates monotherapy in a pediatric HT cohort.
Purpose of the Study:
- To assess the efficacy and safety of calcineurin inhibitor monotherapy in pediatric heart transplant recipients.
- To determine if monotherapy is associated with increased risk of rejection or adverse events.
- To identify patient subgroups who may benefit from reduced immunosuppression.
Main Methods:
- Retrospective review of pediatric heart transplant patients (2001-2020).
- Analysis of patients on calcineurin inhibitor monotherapy for over one month.
- Evaluation of clinical characteristics, reasons for transition to monotherapy, and patient outcomes.
Main Results:
- 5% (16/318) of patients transitioned to monotherapy, primarily due to recurrent infection, PTLD, or neutropenia.
- No moderate or greater rejection episodes or coronary allograft vasculopathy were observed.
- 94% of patients remained alive and well at last follow-up, with 87% continuing monotherapy.
Conclusions:
- Calcineurin inhibitor monotherapy can be a safe and effective strategy for select pediatric heart transplant patients.
- Monotherapy may be preferred in patients with signs of over-immunosuppression.
- This approach does not appear to increase the risk of rejection.
Related Concept Videos
01:28Kidney Transplant I: Introduction
60
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
60
01:16Kidney Transplant III: Nursing Management
82
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
82
01:26Kidney Transplant II: Surgical Procedure
76
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
76
01:14Myocarditis III: Medical Management
16
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
16
01:22Bone Marrow Sampling and Transplants
500
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
500
01:24Tissue Transplantation
520
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
520