Clinical Immunology for Heart Transplant Nurses: Medication Decision-Making.

Heart transplantation offers life-saving therapy for patients with end-stage heart disease, but outcomes depend on precise management of immune risk and immunosuppression. The transplanted heart is a potent antigenic stimulus that can trigger immune pathways, leading to rejection and graft dysfuncti...

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Publicado en:AACN Advanced Critical Care Vol. 37; no. 2; pp. 185 - 204
Autores principales: Coleman, Bernice, Guzman, Ariz Amoroso, Vo, Ashley A.
Formato: CEU review Journal Article
Publicado: American Association of Critical-Care Nurses Summer2026
Acceso en línea:Ver este registro en EBSCOhost
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        atl: Clinical Immunology for Heart Transplant Nurses: Medication Decision-Making.
      aug:
        au:
          Coleman, Bernice
          Guzman, Ariz Amoroso
          Vo, Ashley A.
        affil: Bernice Coleman is Director, Nursing Research and Quality Improvement; Research Scientist III Nurse Practitioner, Heart Transplantation and Mechanical Circulatory Support Programs; Assistant Professor, Biomedical Sciences and Medicine, Cedars-Sinai Medical Center, 6500 Wilshire Blvd, Suite 1220, Los Angeles, CA 90048
      sug:
        subj:
          Heart Transplantation Nursing
          Transplantation Immunology
          Transplant Nurses
          Medication Management
          Decision Making, Clinical
          Transplant Recipients
          Education, Continuing (Credit)
          Heart Diseases Surgery
          Heart Diseases Prognosis
          Risk Assessment
          Immunosuppression
          Graft Rejection
          Critical Care Nurses
          Advanced Practice Registered Nurses
          Nursing Knowledge
          Early Diagnosis
          Patient Education
          Patient Bedside
          Phenotype
          T Lymphocytes Physiology
          Histocompatibility
          Antibody Formation
          Immunosuppressive Agents Therapeutic Use
          Drug Monitoring
          Patient Safety
          Postoperative Care
          Gene Expression Profiling
          Signal Transduction
          Immune System Physiology
          HLA Antigens
          Induction Chemotherapy
          Esterases Antagonists and Inhibitors
          Enzyme Inhibitors Therapeutic Use
          Cell Proliferation Drug Effects
          Adrenal Cortex Hormones Therapeutic Use
          MTOR Inhibitors Therapeutic Use
          Belatacept Therapeutic Use
          Abatacept Therapeutic Use
          Cell-Free Nucleic Acids
      ab: Heart transplantation offers life-saving therapy for patients with end-stage heart disease, but outcomes depend on precise management of immune risk and immunosuppression. The transplanted heart is a potent antigenic stimulus that can trigger immune pathways, leading to rejection and graft dysfunction if not adequately controlled. Intensive care unit nurses and advanced practice registered nurses need a working knowledge of transplant immunology because daily decisions about rejection surveillance, immunosuppressive medication management, early recognition of rejection risk, and patient education are grounded in these mechanisms. Recipient alloactivation occurs through direct and indirect pathways that shape the timing and phenotype of rejection. Acute cellular rejection is primarily T-cell mediated through major histocompatibility complex interactions, while antibody-mediated rejection is driven by donor-specific antibodies against human leukocyte antigens with complement activation and endothelial injury. This review links core immunology to bedside medication monitoring and safer, consistent post-transplant care.
      pubtype: Academic Journal
      doctype:
        CEU
        review
        Journal Article
      ougenre: Article
    language: English
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