Immunosuppressants: what's new?

Current Opinion in Organ Transplantation
Dominic Dell-Olio, Deirdre A Kelly

Abstract

Advances in surgical techniques and combinations of conventional immunosuppressants have made paediatric liver transplantation the success story it is today. However, the increasing numbers of survivors reaching adulthood highlight important issues of long-term quality of life and drug induced complications. The aim of this review is to describe the trends and advances in immunosuppression for paediatric liver transplantation over the last 12 months. As our knowledge of the immune cell populations and intracellular mechanisms involved in alloreactivity improves, induction immunosuppression has emerged as a powerful therapeutic manoeuvre to counter the initial alloimmune response. Many centres have adopted a more focused use of biological agents at induction to improve immunosuppression in the critical peritransplant period and to reduce the level of subsequent maintenance requirements. Corticosteroid avoidance and calcineurin inhibitors minimization trials have obtained encouraging results. New immunosuppressive strategies have evolved towards the goal of inducing operational tolerance, and paediatric liver transplant recipients seem to be a particularly promising target. New strategies are being developed also to improve quali...Continue Reading

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Dec 26, 2015·International Journal of Surgery·Xun ZhuCun-zu Wang
Jun 10, 2014·Pharmacological Reports : PR·Marian Szczepanik
May 3, 2019·Molecular Genetics & Genomic Medicine·Xiaobo YuLin Zhou

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