New developments in immunosuppression

✍ Scribed by James Neuberger

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 81 KB
• Volume: 16
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.22150

✦ Synopsis

Key Points

1. Most liver transplant allograft recipients require long-term immunosuppression, and the most popular therapeutic regimen includes induction therapy, calcineurin inhibitors, corticosteroids, and mycophenolate. 2. Tailoring currently available drugs to the individual may allow better graft outcomes with less toxicity. 3. Many new agents are being evaluated in clinical studies. Among these, belatacept is probably the most studied; other approaches include some new monoclonal antibodies, Janus kinase 3 inhibitors, protein kinase inhibitors, and proteasome inhibitors. 4. New formulations or analogues of existing agents (eg, sublingual tacrolimus and nonnephrotoxic analogues of cyclosporine) may have therapeutic importance in the future. 5. Clinical studies that compare new and existing treatments are difficult to fund and difficult to run. 6. Developments of biomarkers may allow better immunosuppression, the identification of those patients for whom immunosuppression can be withdrawn, and the determination of whether the burden of immunosuppression needs be modified. Liver