Guidelines of the International Society of Heart and Lung Transplantation on immunosuppression after heart transplantation. Part II: immunosuppressive regimens

The first successful heart transplantation was performed in December 1967 by Christiaan Barnard at Groote Schuur Hospital in Cape Town, South Africa. Since then the procedure has been established in specialized centers as the gold standard in the treatment of patients with terminal heart failure. Heart transplantation can be performed safely and provides excellent acute survival rates and due to modern immunosuppressive strategies good long-term results. Regular monitoring of heart transplant recipients is necessary, particularly with regard to asymptomatic rejection episodes. Therefore, different substances inhibiting specific pathways of the immune response are available with different side effect profiles. This article summarizes the evidence and recommendations of the guidelines of the International Society of Heart and Lung Transplantation (ISHLT; Costanzo et al., J Heart Lung Transplant 2010; 29:914-956) on the diagnosis and treatment of heart transplantation patients. The first part of this article deals with diagnostics and available immunosuppressive drugs, the presented second part deals with different immunosuppressive regimens.