Immunosuppression For Kidney Transplantation

All kidney transplant recipients require life-long immunosuppression to prevent a T-cell alloimmune rejection response. Many immunosuppressive agents have been approved by the Federal Drug Administration (FDA), and several more are in phase 3 clinical trials. There are two broad classifications of immunosuppressive agents: intravenous induction/anti-rejection agents, and maintenance immunotherapy agents. There is no consensus as to the single best immunosuppressive protocol and each transplant program utilizes the various combinations of agents slightly differently. The goals of each of the programs are similar: to prevent acute and chronic rejection, to minimize the toxicities of the agents, to minimize the rates of infection and malignancy, and to achieve the highest possible rates of patient and graft survival.

A. Therapeutic Use of Immunosuppression in Kidney Transplantation

1. Induction/Anti-Rejection Immunosuppressive Agents

The term "induction therapy" is generally used to describe antilymphocyte antibody pharmacologics that are parenterally administered for a short course im-

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