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The therapy of rejection
1Division of Nephrology, Ottawa General Hospital, Ontario.
Allograft rejection remains the single largest impediment to success in the field of organ transplantation. Advances in T cell physiology have resulted in refinement of the therapy of rejection. This article briefly reviews a few of the pathogenetic mechanisms underlying rejection and presents a simplified view of pharmacologic effects of the most commonly used agents (azathioprine, corticosteroids, cyclosporine, and polyclonal and monoclonal antibodies). As knowledge increases, it is hoped that one day the transplant physician will be able to specifically suppress the recipient against the donor's antigens, leaving the rest of the immune system intact to protect the host against infections.
Allograft rejection remains the single largest impediment to success in the field of organ transplantation. Advances in T cell physiology have resulted in refinement of the therapy of rejection. This article briefly reviews a few of the pathogenetic mechanisms underlying rejection and presents a simplified view of pharmacologic effects of the most commonly used agents (azathioprine, corticosteroids, cyclosporine, and polyclonal and monoclonal antibodies). As knowledge increases, it is hoped that one day the transplant physician will be able to specifically suppress the recipient against the donor's antigens, leaving the rest of the immune system intact to protect the host against infections.