Cy. Lu et al., PREVENTION AND TREATMENT OF RENAL-ALLOGRAFT REJECTION - NEW THERAPEUTIC APPROACHES AND NEW INSIGHTS INTO ESTABLISHED THERAPIES, Journal of the American Society of Nephrology, 4(6), 1993, pp. 1239-1256
Renal transplantation is the preferred treatment modality for patients
with ESRD who are good surgical risks and able to comply with chronic
immunosuppressive medications. Clinical transplantation has advanced
significantly, with most transplant centers reporting 1-yr renal allog
raft survival rates of better than 80%. Nevertheless, rejection and a
progressive loss of allografts over time continue to occur. The immuno
suppressive agents currently used may lead to the development of life-
threatening infections, malignancies, and advanced atherosclerosis as
a consequence of some of their side effects. This review examines the
mechanisms involved in allograft rejection as currently understood. Th
e recent knowledge into the mechanism of action of cyclosporine, FK506
, and rapamycin on T cell activation is presented. Information recentl
y available on some of the established therapies such as steroids, ant
imetabolites and monoclonal antibodies as well as the newer agents is
also discussed. The interaction between clinical transplantation and b
asic research in immunology continues to result in exciting advances i
n both fields.