[Immunosuppression and treatment of graft rejection after kidney transplantation]

Following the development of new immunosuppressive drugs and improved recognition of immunological events, clinical kidney transplantation has become a routine procedure. At present, 1-year graft survival rates of over 90% are not exceptional. Whilst the baseline immunosuppression is relatively uniformly managed. long-term treatment is subject to different protocols and strategies. In the diagnosis and treatment of acute rejection crises the options are limited. For chronic rejections both concepts for diagnosis and treatment schedules are inadequate. Because there is no one immunosuppressive drug or drug combination that can be used to solve all these problems, it is essential that new drugs or strategies be developed that allow elaboration of individual therapy and, above all, further improvement of the long-term results of kidney transplantation.