Version July 2025
| Drug* | Mechanism of action | Suggested dose | Monitoring | Adverse effects¶ | Comments |
| Anti-thymocyte globulin | Polyclonal antibody that causes nonspecific T cell depletion | Thymoglobulin (rabbit origin): 1.5 mg/kg over 6 hours, then two or three additional doses given 24 hours apart Atgam (horse origin): 7.5 to 15 mg/kg per day for three to five days post transplant Induction protocols may vary by institution | Lymphocytes subsets | Leukopenia, cytokine release syndrome, infusion reactions, thrombocytopenia, glomerulonephritis serum sickness | Premedication includes glucocorticoids (eg, methylprednisolone 125 mg intravenously), antihistamines (eg, diphenhydramine 50 mg orally or intravenously), and antipyretics (eg, acetaminophen 1 g orally) one hour prior to infusion |
| Basiliximab | Chimeric monoclonal antibody (25% mouse, 75% human antibody derived antibody) binds with high affinity to CD25 on T cells to inhibit IL-2 mediated T cell proliferation | 20 mg on the day of transplantation and again on post-op day four | N/A | Low rate of adverse effects. Rarely: hypersensitivity, cytokine release syndrome. | Most commonly used induction agent |
* The US Food and Drug Administration has not approved any medications specifically for lung transplantation, so the doses are suggested based on the experience of large lung transplantation centers.
¶ Immunosuppressants may interact with BCG, live vaccines, and other agents that modulate the immune response, cause myelosuppression or agranulocytosis such as clozapine. For additional interactions, effects, and management suggestions, refer to the drug interactions program included with UpToDate.