Desired Outcome

The major focus of transplant practitioners is to achieve long-term patient and allograft survival.2'8 Short-term outcomes (e.g., acute rejection rates, 1-year graft survival) have improved significantly since the first successful transplant due to an improved understanding of the immune system and enhancements in surgical techniques, organ procurement, immunosuppression, and post-transplant care. Despite the success in improving short-term outcomes, the overall frequency of graft loss remains higher than desired.1,2

It is imperative that transplant practitioners be aware of the specific advantages and disadvantages of the available immunosuppressants, as well as their adverse drug reaction and drug-drug interaction (DDI) profiles. There are generally considered to be three stages of medical immunosuppression: (a) induction therapy, (b) maintenance therapy, and (c) treatment of acute rejection episodes. Overall, the immunosuppressive regimens utilize multiple medications that work on different targets of the immune system. Please refer to Table 55-3 for a list of all currently available immunosuppressive agents.2,8,9

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