Immunosuppression: Evolution in practice and trends, 1994-2004

H. U. Meier-Kriesche, S. Li, R. W.G. Gruessner, J. J. Fung, R. T. Bustami, M. L. Barr, A. B. Leichtman

Research output: Contribution to journalReview article

371 Scopus citations

Abstract

Over the last 10 years, there have been important changes in immunosuppression management and strategies for solid-organ transplantation, characterized by the use of new immunosuppressive agents and regimens. An organ-by-organ review of OPTN/SRTR data showed several important trends in immunosuppression practice. There is an increasing trend toward the use of induction therapy with antibodies, which was used for most kidney, pancreas after kidney (PAK), simultaneous pancreas-kidney (SPK) and pancreas transplant alone (PTA) recipients in 2004 (72-81%) and for approximately half of all intestine, heart and lung recipients. The highest usage of the tacrolimus/mycophenolate mofetil combination as discharge regimen was reported for SPK (72%) and PAK (64%) recipients. Maintenance of the original discharge regimen through the first 3 years following transplantation varied significantly by organ and drug. The usage of calcineurin inhibitors for maintenance therapy was characterized by a clear transition from cyclosporine to tacrolimus. Corticosteroids were administered to the majority of patients; however, steroid-avoidance and steroid-withdrawal protocols have become increasingly common. The percentage of patients treated for acute rejection during the first year following transplantation has continued to decline, reaching 13% for those who received a kidney in 2003, 48% of which cases were treated with antibodies.

Original languageEnglish (US)
Pages (from-to)1111-1131
Number of pages21
JournalAmerican Journal of Transplantation
Volume6
Issue number5 II
DOIs
StatePublished - May 1 2006

Keywords

  • Acute rejection
  • Immunosuppression
  • Induction therapy
  • Maintenance immunosuppression
  • SRTR
  • Transplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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    Meier-Kriesche, H. U., Li, S., Gruessner, R. W. G., Fung, J. J., Bustami, R. T., Barr, M. L., & Leichtman, A. B. (2006). Immunosuppression: Evolution in practice and trends, 1994-2004. American Journal of Transplantation, 6(5 II), 1111-1131. https://doi.org/10.1111/j.1600-6143.2006.01270.x