Treatment of nonhemodynamic compromising rejection: conventional approaches vs individualization/new immunosuppressive drugs
Kobashigawa, J.A.
Transplantation Proceedings 29(8a): 37S-39S
1997
ISSN/ISBN: 0041-1345 PMID: 9414673 Document Number: 471593
Mild rejection may be treated with an increase in oral CyA, but most centers give no therapy and perform a follow-up endomyocardial biopsy within 2 weeks of rejection. Focal moderate rejection is treated similarly to mild rejection; however, there is controversy as to whether focal moderate rejection exists. Asymptomatic moderate rejection is usually treated with an increase in steroids, either i.v. or oral. The therapy for asymptomatic moderate rejection is quite variable and dependent on cardiac hemodynamics, the degree of lymphocytic infiltrates, the interval after heart transplantation, and clinical findings. Symptomatic moderate rejection or severe rejection should be treated with a combination of increased steroids and cytolytic therapy. Other forms of therapy under study may provide more effective methods of treating rejection in the future.