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Immunosuppressive Therapies after Kidney Transplantation: the Old Challenges of New Strategies (pp. 235-260) $100.00
Authors:  (Lucía Alejandra Alfaro Villanueva, Juliana Busato Mansur Siliano, Laila Almeida Viana, Marina Pontello Cristelli, Patricia Cristina Grenzi, Helio Tedesco-Silva Junior, José Osmar Medina-Pestana, and Claudia Rosso Felipe)
Much of the improvement of the outcomes after kidney transplantation is a result of
advances in the immunosuppressive regimens achieved in the last few decades. Yet, due to
regulatory, biopharmaceutical-industry, and transplant-community issues, the prospects for
the development of new drugs have been decreasing in recent years. Thus, judicious use
and perfection of current drug combinations will be paramount to provide continuous
optimization of transplant outcomes. This chapter is divided into three sections. The first
section evaluates the alloimmune response to the kidney graft and discusses the new
concepts of immunological risk evaluation. The second part provides updates regarding
agents that are commonly used for induction immunosuppression according to the
perceived immunological risk and is a critical analysis of the immunosuppressive agents
used for maintenance therapy, emphasizing alternatives that can be further explored with
current registered drugs. Finally, the third section reviews the pharmacokinetics of the
immunosuppressive drugs to provide relevant information to develop further therapeutic
drug monitoring strategies to improve the efficacy/toxicity ratios of the commonly used
immunosuppressive regimens. 

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Immunosuppressive Therapies after Kidney Transplantation: the Old Challenges of New Strategies (pp. 235-260)