**5.2 Standard maintenance immunosuppression, mechanism of action, indication, and outcome**

The strategies of maintenance immunosuppression therapy have improved over time.

Calcineurin inhibitors (CNI), such as cyclosporine and tacrolimus, antimetabolite agent (azathioprine or mycophenolate), and glucocorticoids, are the most common combination of immunosuppressive protocols.

Proliferation signal inhibitors are used for renal insufficiency, cardiac allograft vasculopathy, and malignancy.

The updated guidelines of recipient care for ISHLT recommend:


The most common maintenance immunosuppressive drugs are explained in **Table 6**.


### **Table 6.**

*Maintenance immunosuppressive drugs.*
