An update on clinical outcomes in heart and lung transplantation

Much progress has been made in heart and lung transplantation over recent decades. The immune mechanisms that result in allograft rejection are now better understood, and the development of immunosuppressant therapies has decreased recipient mortality among transplant recipients. During the 1980s, immunosuppressant therapy primarily involved the use of corticosteroids and cyclosporine. However, while survival rates increased among transplant recipients, many patients experienced primary graft failures, acute and chronic rejection, as well as death. Until the introduction of tacrolimus in the early 1990s, all patients received the same immunosuppressant regimen, regardless of its effectiveness. Tacrolimus therapy has contributed much to the success rates of both heart and lung transplantation, and by 2001, it had become the preeminent immunosuppressant agent used in lung transplantation.