title: Current immunosuppressive treatment after kidney transplantation.
abstract: BACKGROUND
  Since 1995, several immunosuppressive drugs have entered the field of organ transplantation: tacrolimus, mycophenolate and the mTOR-inhibitors. Now treating physicians have a choice.
  
  
  METHODS
  The authors review the important studies on immunosuppressive drugs used at present after kidney transplantation, published in the last three decades. This review also discusses the available evidence for selecting one of the calcineurin inhibitors, antiproliferative agents and induction therapy. Interesting new drugs are discussed briefly.
  
  
  CONCLUSIONS
  Calcineurin inhibitors (CNIs) are considered, especially in de novo transplantation, to be the most effective maintenance drugs to prevent acute rejection. Combining CNI with mycophenolate or an mTOR-inhibitor has made it possible to reduce CNI dose and diminish nephrotoxicity. Uniform treatment regimes according to guidelines are useful but should leave room for adjustment to the needs of individual patients. Longer follow-up studies are needed to decide on the optimal maintenance treatment.
authors.affiliation: Erasmus Medical Centre, Department of Internal Medicine , Rotterdam , The Netherlands. m.kho@erasmusmc.nl
authors.forename: Marcia
authors.initials: M
authors.lastname: Kho
authors.forename: Karlien
authors.initials: K
authors.lastname: Cransberg
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
authors.forename: Teun
authors.initials: T
authors.lastname: van Gelder
mesh_terms: D065095:Calcineurin Inhibitors; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D015337:Multicenter Studies as Topic
chemical_list: D065095:Calcineurin Inhibitors; D004791:Enzyme Inhibitors; D007166:Immunosuppressive Agents