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Current immunosuppressive agents: efficacy, side effects, and utilization.

Jodi M Smith1, Thomas Lajos Nemeth, Ruth A McDonald

  • 1Division of Nephrology, Children's Hospital and Regional Medical Center, 4800 Sand Point Way, NE 5G-1, Seattle, WA 98105-0371, USA. jodi.smith@seattlechildrens.org

Pediatric Clinics of North America
|January 9, 2004
PubMed
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Recent advances in immunosuppressive therapy improve graft survival while reducing toxicities. The ultimate goal is inducing immune tolerance to allografts, which is becoming more attainable with ongoing research.

Area of Science:

  • Transplantation immunology
  • Immunosuppressive therapy

Background:

  • Immunosuppressive therapy has significantly improved organ transplant graft survival over the last decade.
  • New immunosuppressive agents are being developed to minimize treatment toxicities.

Purpose of the Study:

  • To review current strategies in immunosuppressive therapy for organ transplantation.
  • To highlight the shift towards minimizing toxicities like infection, nephrotoxicity, malignancy, and cosmetic effects.
  • To discuss the pursuit of immune tolerance as the ultimate goal in transplantation.

Main Methods:

  • Review of recent advancements in immunosuppressive agents and protocols.
  • Discussion of ongoing clinical studies, such as steroid-free and calcineurin avoidance regimens by NAPRTCS (North American Pediatric Renal Transplant Cooperative Study).

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Main Results:

  • Improved graft survival rates due to therapeutic advancements.
  • Emergence of novel immunosuppressive strategies focusing on reduced toxicity.
  • Growing evidence supporting the feasibility of inducing immune tolerance.

Conclusions:

  • Optimizing immunosuppressive regimens is crucial for balancing graft survival and patient safety.
  • Induction of immune tolerance represents the future direction of transplant immunosuppression.
  • Continued basic and clinical research is advancing the goal of allograft tolerance.