ABSTRACT
Over the past decade, advances in immunosuppressive therapies have resulted in lower rates of acute rejection and consequently, significant improvements in patient and graft survival after solid organ transplantation. Increasingly successful outcomes have focused attention on the complications of long-term immunosuppression. Immunosuppressive regimens must be balanced to not only minimize the patient s risk for rejection, but also to avoid the risk of adverse effects such as infection, metabolic complications and noncompliance. Innovative immunosuppressive strategies such as steroid or calcineurin inhibitor avoidance or withdrawal and agents with novel mechanisms of action are currendy being evaluated in an effort to mitigate complications of immunotherapies. This chapter will briefly review the immune response to the allograft and then focus on a review of the efficacies and toxicities of current and future immunosuppressive therapies for prevention and treatment of allograft rejection after solid organ transplantation.
