Standard of Care Triple IS

Standard of care triple maintenance immunosuppression (IS) is a foundational regimen used to prevent organ rejection in heart transplant recipients. As defined in the NIAID-sponsored ALL IN clinical trial (NCT03644667), this regimen typically consists of three pharmacological classes: a calcineurin inhibitor (CNI), an anti-proliferative agent, and a corticosteroid. The CNI component, most commonly tacrolimus (Prograf), inhibits T-cell activation by blocking the production of interleukin-2. The anti-proliferative component, usually mycophenolate mofetil (CellCept) or mycophenolate sodium (Myfortic), suppresses lymphocyte proliferation by inhibiting inosine-5'-monophosphate dehydrogenase (IMPDH). The corticosteroid component, such as prednisone or methylprednisolone, provides broad anti-inflammatory and immunosuppressive effects through glucocorticoid receptor modulation. This triple-drug approach targets multiple pathways of the alloimmune response to optimize graft survival while balancing the risks of toxicity and infection.

Brand names

PrografCellCeptMyfortic

Other names

Standard Triple Maintenance ImmunosuppressionTriple Therapy Immunosuppressiontacrolimus + mycophenolate mofetil + prednisonestandard of care triple is-National Institute of Allergy and Infectious Diseases (NIAID)-heart transplant rejection