Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.
Semin Respir Crit Care Med. 2010 Apr;31(2):172-8. doi: 10.1055/s-0030-1249112. Epub 2010 Mar 30.
Lung transplant has become an established therapy in the treatment of end-stage lung disease. Many of the advances in the modern immunosuppression regimen have provided more quality and quantity of life to transplant patients. Immunosuppression agents target various aspects of the immune system to maximize graft tolerance while minimizing medication toxicities and side effects. Lung transplant regimens follow typical protocols but are always tailored to the individual patient based upon previous and current medical problems. Despite the various advances, acute and chronic rejections still occur in the majority of all lung transplants. For these reasons, long-term lung transplantation success remains a challenge. Further improvement in immunosuppression will be geared toward minimizing rejection and infection as well as being tailored to the individual patient. This review details the current armamentarium of immunosuppression medications and the current body of evidence supporting the current trends of usage.
肺移植已成为治疗终末期肺病的一种既定疗法。现代免疫抑制方案的许多进展为移植患者提供了更高的生活质量和更长的生存时间。免疫抑制剂靶向免疫系统的各个方面,以最大限度地提高移植物耐受性,同时将药物毒性和副作用降至最低。肺移植方案遵循典型的方案,但始终根据患者以前和当前的医疗问题进行个体化调整。尽管取得了各种进展,但大多数肺移植仍会发生急性和慢性排斥反应。由于这些原因,长期肺移植的成功仍然是一个挑战。免疫抑制的进一步改进将侧重于最小化排斥反应和感染,并针对个体患者进行调整。本综述详细介绍了目前的免疫抑制药物以及支持当前使用趋势的现有证据。