Review of Major Drug-Drug Interactions in Thoracic Transplantation

Abstract

The first human lung transplant surgery in the world was done in 1963, followed by the first heart transplant in 1967, making this year its 50th anniversary. Since then, there has been great advancement in immunotherapy, with the adoption of calcineurin inhibitors (CNI), mycophenolate mofetil, and proliferation signal inhibitors (PSI). However, while these medications are crucial to maintenance of allograft function and prevention of allograft rejection, they have many toxicities and side effects, which make therapeutic dose monitoring and recognition of drug-drug interactions of critical importance. Most of drug-drug interactions in transplant medicine can be explained through the mechanism of CYP3A4 and P-glycoprotein. A large component of the medical management of post-transplant care is in the appropriate utilization of immunosuppression drugs while minimizing side effects and drug-drug interactions.