Induction therapy in lung transplantation

Strategies for induction in lung transplant recipients typically mirror those used in other solid organ transplant recipients. Polyclonal (Atgam, RATG) and monoclonal (OKT3) T-cell depleting agents, IL-2 Receptor antagonists (basiliximab and daclizumab) have been used most commonly. In spite of evidence from ISHLT registry reports that induction reduces acute rejection and has a small benefit in freedom from bronchiolitis obliterans and long-term survival, other studies have been less convincing in terms of long-term benefit. Future iterations of induction strategy for lung transplant recipients will hopefully utilize tolerogenic approaches currently being tested in renal transplantation.