Immunosuppression in older renal transplant patients

Renal transplantation procedures in patients older than 60 years of age hav e clearly improved in recent years. In the cyclosporin era, graft and patie nt survival are good. However, older patients exhibit a higher mortality, e specially from infectious and cardiovascular causes, than young patients. I n this article we review the immunosuppressive treatment in older patients, analyse what drugs can be used and finally propose several immunosuppressi ve combinations to treat this group of patients. Currently, new immunosuppr essive drugs enable more flexible immunosuppressive protocols. Nevertheless , to avoid overimmunosuppression, elderly patients should be treated with l ower doses and fewer immunosuppressive drugs.