NEW IMMUNOSUPPRESSIVE REGIMENS IN LUNG TRANSPLANTATION

Survival after lung transplantation is less than 50% after 5 yrs and i s limited by infection and obliterative bronchiolitis. There is, there fore, a need for new immunosuppressive regimens if we are to attempt t o improve long-term survival, Several trials in lung transplantation o f new immunosuppressive agents are in the planning stages, In this art icle, we review the experience with a new monoclonal agent (interleuki n 2 (IL2) receptor antagonist) in kidney transplantation, together wit h the pharmacokinetic (PK) and pharmacodynamic properties and experien ce in transplantation in general, of the more promising of the new xen obiotic compounds (cyclosporine microemulsion, mycophenolate mofetil, tacrolimus and sirolimus), Recent novel approaches to the vexing probl em of resistant lung rejection and obliterative bronchiolitis, such as the use of aerosolized cyclosporine, methotrexate, total lymphoid irr adiation and phototherapy, are discussed, Finally an immuno-suppressiv e regimen, using these new drugs in lung transplantation is suggested.