Precision Immunosuppression in Kidney Transplantation: A Comprehensive Review

Area of Science:

• Nephrology
• Immunology
• Pharmacogenomics

Background:

• Kidney transplantation traditionally relies on "trial-and-error" immunosuppression dosing.
• This approach can lead to suboptimal graft outcomes and increased toxicity.
• A shift towards individualized immunosuppression is emerging.

Purpose of the Study:

• To review current evidence on individualized immunosuppression in kidney transplant.
• To examine the roles of pharmacokinetics, pharmacogenomics, and biomarkers.
• To outline future directions for tailored posttransplant care.

Main Methods:

• Literature review of studies on individualized immunosuppression in kidney transplant.
• Analysis of pharmacogenetic data, biomarkers, and therapeutic drug monitoring.
• Inclusion of artificial intelligence-based prediction models.

Main Results:

• Individualized regimens improve kidney graft outcomes.
• Precision immunosuppression reduces treatment-related toxicity.
• Stratified risk assessment remains crucial for patient selection.

Conclusions:

• Optimized immunosuppressive therapy enhances graft survival and patient safety.
• Pharmacogenetics and biomarkers are key to personalized immunosuppression.
• Tailored strategies enable targeted minimization of immunosuppression in select patients.