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Among different limitations in this peculiar field, the experimental pharmacological management of patients who undergo heart xenotransplantation is primarily narrowed by the indications for which these drugs have been previously authorized by international medicines agencies. In fact, many of these medications have been never authorized for transplant rejection therapy, or for xenotransplantation, but their mechanism of action might stop the molecular pathways which are involved in xenograft antibody\u2010mediated rejection. Additionally, drugs costs and supply can restrict their availability for xenotransplantation practice. The aim of this review is to describe the current drugs which have been used in the clinical cases of heart xenotransplantation performed to date, to analyze the indications for which they are authorized, and to evaluate the future medications which might be implemented in heart xenotransplantation field, with a particular focus on the European scenario.<\/jats:p>","DOI":"10.1111\/xen.70061","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T01:58:28Z","timestamp":1751335108000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Immunosuppressive and Non\u2010Immunosuppressive Drugs for Heart Xenotransplantation in Humans: Is Europe Ready?"],"prefix":"10.1111","volume":"32","author":[{"given":"Nicola","family":"Pradegan","sequence":"first","affiliation":[{"name":"Cardiac Surgery Unit and Heart Transplant Program Padova University Hospital  Padua Italy"},{"name":"Department of Cardiac Thoracic and Vascular Science and Public Health Cardiovascular Regenerative Medicine Lab, University of Padova  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Tolomeo","sequence":"additional","affiliation":[{"name":"Department of Cardiac Thoracic and Vascular Science and Public Health Cardiovascular Regenerative Medicine Lab, University of Padova  Padua Italy"},{"name":"Institute of Pediatric Research \u201cCitt\u00e0 della Speranza\u201d  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Ciccarelli","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit and Heart Transplant Program Padova University Hospital  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Cozzi","sequence":"additional","affiliation":[{"name":"Institute of Pediatric Research \u201cCitt\u00e0 della Speranza\u201d  Padua Italy"},{"name":"Department of Cardiac Thoracic and Vascular Science and Public Health Transplant Immunology Lab, University of Padova  Padua Italy"},{"name":"Transplant Immunology Unit Padova University Hospital  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Vitiello","sequence":"additional","affiliation":[{"name":"Pharmacy Department National Health Ministry  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Zovi","sequence":"additional","affiliation":[{"name":"Pharmacy Department National Health Ministry  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gino","family":"Gerosa","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit and Heart Transplant Program Padova University Hospital  Padua Italy"},{"name":"Department of Cardiac Thoracic and Vascular Science and Public Health Cardiovascular Regenerative Medicine Lab, University of Padova  Padua Italy"},{"name":"Institute of Pediatric Research \u201cCitt\u00e0 della Speranza\u201d  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2020.100585"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.12592"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac180"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0041\u20101345(98)01855\u20107"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1053\u20102498(99)00099\u20106"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010018\u20100765\u2010z"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms11138"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2201422"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(23)00775\u20104"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010023\u201002471\u20109"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010024\u201003429\u20101"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2024.07.022"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.13942"},{"key":"e_1_2_8_15_1","unstructured":"European Medicines Agency [Internet]. 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