New medication options

Mayo Clinic researchers study medications and treatments for people with heart transplants, including new medications (immunosuppressant medications) to keep your body from rejecting your heart transplant.

In the past, people with heart transplants usually took corticosteroids (prednisone, others) and other immunosuppressant medications for life to prevent rejection. However, corticosteroids may cause many side effects and complications such as weight gain, diabetes, high blood pressure and osteoporosis.

You may be able to reduce or stop taking corticosteroids at some time after your heart transplant, which may lessen your side effects and complications. You'll still need to take other immunosuppressant medications.

Researchers also study lowering the dose of immunosuppressant medications, such as calcineurin inhibitors, to reduce complications such as kidney function problems.

Mayo doctors may prescribe an immunosuppressant called sirolimus (Rapamune) for some people who have had heart transplants. Doctors may recommend some people use sirolimus instead of calcineurin inhibitors. If used with calcineurin inhibitors, the dose of the calcineurin inhibitors is usually reduced, or may be discontinued.

Sirolimus may help slow the progress of kidney problems or improve kidney function. This medication may also help slow or prevent the progress of a disease that can occur after a heart transplant called cardiac allograft vasculopathy. In this disease, the walls of the arteries in your heart (coronary arteries) thicken and harden, which can cause limited blood flow through your heart.

Other immunosuppressant medication options that have increased in use for people with heart transplants include basiliximab (Simulect), anti-thymocyte globulin, rabbit (Thymoglobulin), mycophenolate mofetil (CellCept) and mycophenolic acid (Myfortic).