Postoperative Immunsuppression

Although the donor heart comes from a donor with an identical blood group, there is a lot of genetic information that the recipient’s immune system recognises as foreign. In order to avoid a reaction completely, the donor organ would have to come from a genetically identical person, which would only be possible with an identical twin. As this is usually not the case in a heart transplant, it is necessary even before and during the operation to give medications designed to diminish recognition of the organ as foreign and prevent rejection as far as possible.

Unfortunately, these immunosuppressive drugs are not so specific that they prevent only the body’s reaction to the foreign organ; the body’s immune response to outside intruders – including bacteria, viruses or fungi – is also weakened. This is why the combination and dosage of immunosuppressants is a permanent balancing act between suppression of the rejection reactions and the associated risk of increased susceptibility to infection. However, the quantity and number of immunosuppressive medications necessary to prevent rejection can be reduced gradually in most patients later in their post-transplant course.