Current Use of Immunosuppression in Liver Transplantation

The first liver transplant, performed by Dr Thomas Starzl in 1967, used a combination of azathioprine, steroids, and heterolygous antilymphocyte globulin (ALG) for immunosuppression.1 Mitigating the balance between immunologic rejection of the allograft and vulnerability to opportunistic infection, Starzl and colleagues recognized the importance of tapering immunosuppression (ie, Steroids) and eventual discontinuation of ALG. In 1979, Dr Roy Calne introduced cyclosporine, a calcineurin inhibitor, which enabled a new era in liver transplantation of superior clinical outcomes as an plantation technique and the introduction of calcineurin inhibitors, 1-year patient surIn the current era of liver transplantation, 1-year adult patient survival now approaches 93.6%, mainly attributed to improvements in immunosuppression and