[Renal transplant and chronic rejection in pediatrics]

The rapid advances in immunobiology, pharmacology and molecular biology have made successful renal transplantation the optimal therapeutic modality for adults and children, reaching a near--90% of patient-graft survival among the first years of transplant. But this knowledge also presents clinicians and scientists with difficult challenges, one of the most important remaining is the chronic rejection of the graft. A critical review of the immunobiology, clinical evolution and histopathology of chronic rejection is presented. Immunosuppressive agents with emphasis in their mechanism of action is also detailed.