Immunosuppression in lung transplantation: a narrative review

Abstract

Background and Objective: Lung transplantation has grown as a treatment option for patients with end stage lung disease. Unfortunately, median survival for lung transplant recipients remains low at 6.7 years. Acute rejection and chronic lung allograft dysfunction (CLAD) are among the main challenges to graft function and overall survival. Immunosuppression is utilized to reduce the rate of rejection, and can be utilized as a treatment for acute rejection and CLAD. The purpose of this review is to describe the immunosuppressive agents used in lung transplantation for induction therapy, maintenance therapy, and prevention of both acute and chronic allograft rejection.Methods: PubMed was searched using keywords including "lung transplantation, immunosuppression, induction, maintenance" from January 1985 to June 2022. Systematic reviews, randomized clinical trials, retrospective and cross-sectional studies, case series, and some animal studies were considered for inclusion in this review, with no language restrictions.