Immunosuppressive Therapy Protocols in Kidney Transplantation in Adults

Jasenko Karamehić,Đemo Subašić,Bećir Heljić,Marc Lorber,Richard Formica,Lamija Zečević,Faris Gavrankapetanović

doi:10.17305/bjbms.2006.3143

Abstract

In practical terms, regardless of HLA compatibility level, whenever tissues are transplanted from one person to another it is essential to suppress the immune response of the recipient. A variety of methods are available however, the most frequently used ones have the disadvantage of being immunologicaly non specific. The consequence is a difficult balance between immunosuppression sufficient to prevent the tissue rejection and maintenance of immune system at the level of ability to adequately deal with an infection. The goal, not yet achieved, is to find a way of generating donor specific immunosuppression that leaves the immune machinery otherwise completely intact. The major approaches to immunosuppression are described below.

Highlights

Along with an increase in the frequency of organ transplantation and acquisition of new organs for transplantation, the interest in chemical immunosuppression has dramatically increased
In the s, the choice of immunosuppressive drugs was limited to azathioprine and steroids and, in the s, polyclonal anti-lymphocyte and thymocyte globulins were added to the list ( )
General clinical approaches are usually divided into four main strategies: termed induction, acute rejection prophylaxis, maintenance immunosuppression and acute rejection therapy (, )

Summary

Introduction

Along with an increase in the frequency of organ transplantation and acquisition of new organs for transplantation, the interest in chemical immunosuppression has dramatically increased. In the s, the choice of immunosuppressive drugs was limited to azathioprine and steroids and, in the s, polyclonal anti-lymphocyte and thymocyte globulins were added to the list ( ). A real breakthrough occurred in s, when the first generation selective immunosuppressant, Cyclo-. JASENKO KARAMEHIĆ ET AL.: IMMUNOSUPPRESSIVE THERAPY PROTOCOLS IN KIDNEY TRANSPLANTATION IN ADULTS sporin (CsA), was introduced. In the early s, a wide range of third generation immunosuppressants with highly specific sites of actions emerged. Most of these are currently in clinical trials ( , )

Objectives

Discussion

Conclusion