Premium
Immunosuppressive agents in transplantation: Mechanisms of action and current anti‐rejection strategies
Author(s) -
Gorantla Vijay S.,
Barker John H.,
Jones Jon W.,
Prabhune Kaustubha,
Maldonado Claudio,
Granger Darla K.
Publication year - 2000
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/1098-2752(2000)20:8<420::aid-micr13>3.0.co;2-o
Subject(s) - medicine , immunosuppression , tacrolimus , calcineurin , allotransplantation , transplantation , organ transplantation , adverse effect , immune system , toxicity , immunology , pharmacology , intensive care medicine
Over the past century, the concept of interfering with the immune response at various sites by blocking the formation, stimulation, proliferation, and differentiation of lymphocytes has led to relentless development of new immunosuppressive drugs. These agents are associated with reduced risk of short‐ and long‐term toxicity and have dramatically improved allograft and patient survival, especially in recipients of solid organ transplants. Current protocols in such patients are nearly all calcineurin‐inhibitor based, using cyclosporine or tacrolimus, as part of dual, triple, or sequential therapy. This review focuses on agents currently in clinical use at transplant centers in United States. The drugs are described in terms of their basic mechanisms of action, therapeutic uses, clinical studies, and adverse effects. In addition, the efficacy and toxicity of a few promising new therapeutic approaches are examined. Finally, important challenges regarding pharmacological immunosuppression as it relates to solid organ and composite tissue allotransplantation are discussed. © 2000 Wiley‐Liss, Inc. Microsurgery 20:420–429 2000