Period	Immunosuppressive regimen
1990–1994	Cyclosporin(a) at higher-than-standard doses; initial trough levels 550–664 ng/ml11
1994–2007	Cyclosporin(a) continued at progressively lower doses than isolated cardiac transplant recipients (years 5–10: 87–107 ng/ml; years 10–12: 53–80 ng/ml; years 12+: 35–50 ng/ml), reflecting hepatic immunological privilege. MMF 250 mg twice daily added from 200211
2007–2013	Conversion from cyclosporin(a) to sirolimus 3 mg once daily (plus MMF 250 mg twice daily), in attempt to preserve renal function11
September 2013	Biopsy-confirmed Grade 1R cardiac rejection on sirolimus. Pulse methylprednisolone. Conversion to ciclosporin initiated
June 2014	Presumed second rejection episode (negative biopsy; response to three-day pulse methylprednisolone consistent with false-negative result). Ciclosporin consolidated
Current (2026)	Ciclosporin (Neoral) 75 mg AM / 50 mg PM (dose reduced from 75 mg BD at 14/05/2026 clinic following trough of 155 ng/ml; target 100–120 ng/ml); MMF 250 mg twice daily. Atorvastatin 10 mg od; Ezetimibe 10 mg od