Pharmacological Manipulation of the Rejection Response

Immunosuppressive strategies continue to evolve, with a number of new formulations having been developed in recent years. Although acute rejection rates may have diminished, current protocols of immunosuppression for chronic organ rejection are clearly inadequate. This complication remains the primary cause of graft loss months to years after solid organ transplant. In summary, the overall goal of achieving immune tolerance remains elusive. This chapter will focus on the pharmacological manipulation of the rejection response, reviewing historical and current recommended protocols. A brief outline of potential future pathways of targeted immunosuppression is described.