Cardiac transplantation: Immunobiology and immunotherapy

Abstract

The first successful heart transplant in 1967 brought hope for those with end-stage heart disease. Unfortunately, survival posttransplant was limited in the early years, mainly due to acute rejection and complications from immunosuppressive therapy. Over the decades, advances in tissue typing and donor-recipient matching, as well as in immunotherapy gradually increased the numbers of patients receiving heart transplants and their survival rates. This chapter details the immune system and its critical role in transplant success. It also describes how various immunosuppressive agents can overcome challenges posed by the immune system and lead to enhanced acceptance/tolerance of the donor heart.