New immunosuppressive drugs in heart transplantation

Table 1 Induction immunosuppressive drugs

Agent	Molecular target	Molecular effect	Specific side effects	Comments
ATG/ALG	Binds multiple antigens on lymphoid cells	Complement-mediated lysis	Serum sickness	Batch variability
		Opsonization and clearance	Thrombocytopenia
		Modification of cell surface receptor	Granulocytopenia
OKT3	Binds T cell CD3	Complement mediated lysis	Cytokine release syndrome	Tachyphylaxis due to anti-idiotypic antibodies
		Opsonization and clearance	(eg fever, chills, headache, and pulmonary edema)
		Modification of CD3 receptor
Daclizumab	Binds α-subunit of interleukin-2 receptor	Down-regulation of receptor	No major side effects reported so far	Humanized antibody
		? CD4 T cell depletion		Long half-life (20 days)
				Five-dose regimen
Basiliximab	Binds α-subunit of interleukin-2 receptor	Down-regulation of receptor	No major side effects reported so far	Chimeric antibody
		? CD4 T cell depletion		Long half-life (10-14 days)
				Two-dose regimen

ISSN: 1745-6215