Evolution of Superior Immune Suppression for Heart and Heart-Lung Transplantation
Conventional immune suppression protocols for heart transplantation were adapted from the successful use of azathioprine, prednisone, and antithymocyte globulin for kidney transplantation. Even in the leading centres, however, one-year survival rates following heart transplantation of only 60% were possible (1). Although lung and combined heart-lung transplantation appeared with the early flourish of heart transplantation in the late 1960s and early 70s, the lack of survivors delayed resurgence in these fields until superior immune suppression could be found (2,3). A superior form of immune suppression has been needed, and until the emergence of cyclosporine, improvements have not been possible (4).
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