title: Current immunosuppressive agents: efficacy, side effects, and utilization.
abstract: Advances in immunosuppressive therapy over the past decade have led to dramatic improvements in graft survival. With the development of new agents, the focus of the transplant community is to establish regimens that maintain excellent graft survival rates but with fewer toxicities including infection, nephrotoxicity, malignancy, and cosmetic effects. Examples include the use of steroid-free protocols and calcineurin avoidance regimens, which are currently being studied by NAPRTCS. The ultimate goal of transplant immunosuppressive therapy is the induction of tolerance. As we learn more about immune function from basic and clinical research, tolerance to allografts seems a more reachable goal.
authors.affiliation: Division of Nephrology, Children's Hospital and Regional Medical Center, 4800 Sand Point Way, NE 5G-1, Seattle, WA 98105-0371, USA. jodi.smith@seattlechildrens.org
authors.forename: Jodi M
authors.initials: JM
authors.lastname: Smith
authors.forename: Thomas Lajos
authors.initials: TL
authors.lastname: Nemeth
authors.forename: Ruth A
authors.initials: RA
authors.lastname: McDonald
mesh_terms: D000069594:Abatacept; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D019540:Area Under Curve; D000077552:Basiliximab; D016572:Cyclosporine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D000077561:Daclizumab; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D000068338:Everolimus; D000068876:Fingolimod Hydrochloride; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use; D007074:Immunoglobulin G / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D016853:Muromonab-CD3 / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011409:Propylene Glycols / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013110:Sphingosine / Q000031:analogs & derivatives; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000961:Antilymphocyte Serum; D018796:Immunoconjugates; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D011409:Propylene Glycols; D011993:Recombinant Fusion Proteins; D000074323:Alemtuzumab; D000069594:Abatacept; D016572:Cyclosporine; D000077552:Basiliximab; D000068338:Everolimus; D000077561:Daclizumab; D000068876:Fingolimod Hydrochloride; D009173:Mycophenolic Acid; D013110:Sphingosine; D020123:Sirolimus; D016559:Tacrolimus