Abstract：
Advances in maintenance immunosuppression over the past three decades have improved solid organ transplantation outcomes dramatically. Uninterrupted access to immunosuppression is paramount to minimize rejection and maintain allograft and patient survival. There is no standardized approach to maintenance immunosuppression management. Agents used vary based on transplanted organ, center-specific protocol, provider expertise, insurance formularies, ability to cover co-pays, recipient characteristics and tolerability. Published data reflects this heterogeneity. Despite this limitation, maintenance immunosuppression usage cross pollinates between organ groups with standard of care agents often being used off-label, making medication access a challenge for many transplant recipients. A multidisciplinary panel of American transplant clinicians was formed to review published literature on maintenance immunosuppression with the goal to formulate consensus recommendations for their use in specific organ groups. These consensus recommendations are intended to provide transplant clinicians with a summary of literature on maintenance immunosuppression in the modern era and to support transplant team members working to secure medication access for patients.
摘要：
在过去的三十年中，维持免疫抑制的进展显着改善了实体器官移植的结果。不间断地获得免疫抑制对于最大程度地减少排斥并维持同种异体移植物和患者存活至关重要。维持免疫抑制管理没有标准化的方法。使用的药物因移植器官而异，特定于中心的协议，提供商的专业知识，保险处方，支付共同支付的能力，受体特征和耐受性。已发布的数据反映了这种异质性。尽管有这种限制,维持免疫抑制使用在器官组之间交叉授粉，通常在标签外使用标准护理剂，使药物获得对许多移植接受者来说是一个挑战。组成了一个多学科的美国移植临床医生小组，以审查有关维持免疫抑制的已发表文献，目的是为其在特定器官组中的使用制定共识建议。这些共识建议旨在为移植临床医生提供有关现代维持免疫抑制的文献摘要，并支持移植团队成员努力确保患者获得药物。
