Keith C. Meyer • Allan R. Glanville
Editors
2013
It has been 50 years since the fi rst successful human lung transplant was reported in 1963 by Hardy and colleagues. However, the success of this fi rst transplant was transient, and outcomes remained poor until the early 1980s, when cyclosporine A (CsA) was fi rst used for clinical immunosuppression. This was associated temporally with improved techniques for donor lung preservation, better surgical techniques, and advances in postoperative management. Most importantly, after an initial experience with dual immunosuppression (CsA and corticosteroids), it was found that a triple drug regimen of CsA, azathioprine, and corticosteroids given post-transplant could prevent acute rejection quite effectively. In the 1990s another calcineurin inhibitor (tacrolimus) and antimetabolite (mycophenolate) became available as alternates to CsA and azathioprine, respectively. Along with improved post-transplantation triple-drug immunosuppression, prophylactic regimens were devised over the past 2 decades to prevent opportunistic infection with viruses (cytomegalovirus and herpes simplex) and fungi ( Candida , Aspergillus , and Pneumocystis )…
Bronchiolitis Obliterans Syndrome in Lung Transplantation
