Drugs used in Heart transplants

Posted by Julie Hirschmanner on May 02, 1999 at 03:26:35
I am a university student, and as part of a research assignment, I must discuss what drugs are used before, during and after the heart transplant operation. Are there any drugs used other the immunosuppressants?  Which immunospuuressants are used?  Is there any drugs needed to be taken before the operation?  Any information relevant to the drugs used before, during and after the operation would be useful.
Your help is much appreciated.

Posted by CCF CARDIO MD - MTR on May 02, 1999 at 21:42:51
Dear Julie, thank you for your question.  Most patients awaiting heart transplantation are on powerful drugs to stimulate their hearts to beat more efficiently and to prepare them for transplanation.  These medications are called dobutamine and milrinone and are referred to as inotropes.  An alternative to inotropes is an implanted device termed a left ventricular assist device (LVAD).  LVAD's assist the pumping function of the heart to limit congestive heart failure and improve the overall well-being of a patient awaiting transplantation.   Immunosuppressants are not given before heart transplantation to limit infectious complications.  At the time of transplantation, a cocktail of three immunosuppressants is begun intravenously and then are converted to oral medications a few days later.  The three immunosuppressants typically given are steroids (Prednisone), cyclosporine, and immuran or mycophenalate.   Each of these three medications inhibits a different part of the immune response to prevent rejection of the transplanted heart.  These immunosuppressants are initially given at very high doses and are then reduced over the next weeks to months.  Typically, all 3 immunosuppressants are given for at least the first few years following transplantation.  If you would like more information, I suggest that you find a cardiology or heart transplantation textbook at a local medical library.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart
Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.