Abstract
Long-term graft survival is the desired outcome of organ transplantation. The surrogate metric elimination of acute rejection episodes is not only inadequate but also deceptive, since this freedom does not promise long-term graft survival. Current clinical immunosuppressive agents have reduced acute rejection, but not prolonged graft survival. New paradigms in organ transplantation focus on adhesion-migration events using a selectin antagonist, an antisense oligonucleotide, and FTY 720; on peptide or allochimeric antigens on cytokine disruption, and on inhibition of costimulatory signals. Due to the array of adverse reactions to the available immunosuppressive drugs, these new approaches aim not only to augment long-term graft survival, but also minimize the associated toxicities.
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