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Previous Volume 351:2715-2729 December 23, 2004 Number 26 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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The central issue in organ transplantation remains suppression of allograft rejection. Thus, development of immunosuppressive drugs is the key to successful allograft function. Immunosuppressive agents are used for induction (intense immunosuppression in the initial days after transplantation), maintenance, and reversal of established rejection. This review focuses on agents that are either approved or in phase 2 or phase 3 trials in kidney transplantation, but many issues covered here are applicable to all organ transplantation. I begin with a model of the alloimmune response to illustrate how these medications act.

Three-Signal Model of Alloimmune Responses

Alloimmune responses involve both naive and memory lymphocytes,¹ including lymphocytes previously . . . [Full Text of this Article]

Effectors and Lesions of Rejection

Host–Graft Adaptation

Immunosuppressive Drugs

Classification of Immunosuppressive Drugs

Small-Molecule Drugs

            Calcineurin Inhibitors

            Inosine Monophosphate Dehydrogenase Inhibitors

            Target-of-Rapamycin Inhibitors

            Dihydroorotate Dehydrogenase Inhibitors

            FTY720

Depleting Antibodies

Nondepleting Antibodies and Fusion Proteins

            Daclizumab and Basiliximab

            LEA29Y

Additional Drugs

Protocol Development and Emerging Issues

Source Information

From the Division of Nephrology and Transplantation Immunology, University of Alberta, Edmonton, Canada.

Address reprint requests to Dr. Halloran at 250 Heritage Medical Research Centre, Edmonton, AB T6G 2S2, Canada, or at phil.halloran@ualberta.ca.

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