Board Certification Review 2023 Spotlight: Cardiac Transplantation-Managing Immunosuppression and Drugs

Video Transcription

Video Summary

The video discusses heart transplantation and the management of immunosuppression and drugs. It focuses on different immunosuppressive options and their side effects, as well as tailoring therapy to individual patients. The cornerstones of immunosuppression are prednisone, calcineurin inhibitors, antimetabolites, and proliferation signal inhibitors. Prednisone is typically given in the operating room and gradually reduced over time. The side effects of prednisone can be short-term or long-term. Calcineurin inhibitors, such as tacrolimus and cyclosporine, can cause hypertension and nephrotoxicity. Tacrolimus is generally preferred over cyclosporine. Antimetabolites, like mycophenolate, are commonly used and have fewer side effects compared to azathioprine. Proliferation signal inhibitors, such as sirolimus and everolimus, have benefits but also side effects, such as edema and hypertriglyceridemia. The video also discusses drug-drug interactions and the impact of the denervated transplanted heart on drug response. The importance of tailoring therapy and considering individual patient factors is emphasized. Overall, the goal is to find the most effective immunosuppressive regimen while minimizing side effects and drug interactions.

Keywords

heart transplantation

immunosuppression

side effects

prednisone

calcineurin inhibitors

antimetabolites