Abstract
AbstractKidney transplantation is the treatment of choice for end-stage renal disease. Transplantation of an organ from a genetically different donor initiates activation of the recipient’s immune system, in particular T cells, against the graft cells. This corresponds to the alloreactivity phenomenon at the root of rejection. The development of immunosuppressive treatments active on T cells has reduced the incidence of rejection, leading to increased survival of transplanted organs. Immunosuppression protocols combine induction treatments, followed by lifelong maintenance treatments. This article describes the mechanisms of action of immunosuppressive drugs and the treatment regimens used in current practice. It describes the biological monitoring of these treatments, the interactions that can alter their maintenance within therapeutic targets, and their biological consequences, which justify the implementation of specific, individualized biological monitoring.
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