[Immunosuppressors]

Abstract

In the past two decades, new immunosuppressive drugs have emerged that have achieved a significantly reduction in acute rejection and short-term graft survival. This improvement, however, has not had the expected impact on long-term survival of the transplant. Paradoxically, the most used and effective drugs to prevent acute rejection are calcineurin inhibitors, but they contribute to delayed graft loss and patient death because they are nephrotoxic and also cause other adverse effects on blood pressure, lipid metabolism and glucose homeostasis. It was therefore necessary to develop new molecules free from these side effects that allow the use of low-dose or calcineurin inhibitor-free regimens without causing other adverse effects on patient and graft survival. Thus, the great development in the field of immunology has led to the discovery of important new pathways in the alloimmune response and subsequent development of molecules that act selectively against different points in the activation of the immune cascade. In this article we will review the most relevant clinical data published on immunosuppression and presented at different congresses over the year 2007, selecting those that we considered most relevant and that may have impact on the treatment of our patients in the future.