Immunosuppression Strategies in Heart Transplantation

Initial immunosuppressive efforts in human cardiac transplantation were hindered by poor outcomes that resulted from suboptimal regimens, with the result frequently being overwhelming infection or allograft rejection. Initially, at the advent of modern cardiac transplantation, 1-year survival in the 1970s hovered around 50%. At this stage, the only viable immunosuppressive techniques were the use of azathioprine, a purine analogue, and total body irradiation, both with many adverse effects.