A 56-year-old woman with a history of heart failure is admitted to the hospital for orthotopic cardiac transplantation. The patient developed biventricular failure due to idiopathic myocarditis. She has had persistent New York Heart Association class IV symptoms refractory to maximal medical therapy and was placed on the transplant waiting list. An ABO-compatible cadaveric heart is available for transplant with partial human leukocyte antigen (HL A) mismatch. Cardiac transplantation is performed and the patient's T lymphocytes quickly recognize the foreign HLA molecules of the transplant cells. Inhibition of which of the following substances would specifically reduce the proliferation and differentiation of these T lymphocytes?

Question

A 56-year-old woman with a history of heart failure is admitted to the hospital for orthotopic cardiac transplantation.  The patient developed biventricular failure due to idiopathic myocarditis.  She has had persistent New York Heart Association class IV symptoms refractory to maximal medical therapy and was placed on the transplant waiting list.  An ABO-compatible cadaveric heart is available for transplant with partial human leukocyte antigen (HL A) mismatch.  Cardiac transplantation is performed and the patient's T lymphocytes quickly recognize the foreign HLA molecules of the transplant cells.  Inhibition of which of the following substances would specifically reduce the proliferation and differentiation of these T lymphocytes?

Quizplus · Accepted Answer

Eductional Objective: Calcineurin is an essential protein in the activation of interleukin-2, which promotes the growth and differentiation of T cells.  Immunosuppressants such as cyclosporine and tacrolimus work by inhibiting calcineurin activation.

A 56-Year-Old Woman with a History of Heart Failure Is