Modern immunosuppression

Transplantation is the optimal treatment for selected patients with end-stage organ failure, increasing life expectancy and improving quality of life. Transplant success requires the host immune response to be controlled sufficiently to prevent rejection while permitting a protective immune response to pathogens.Modern immunosuppression uses a combination of agents targeting different points in the immune response. Such an approach permits optimal immunosuppression while minimizing drug-specific side effects. This article provides an overview of the main classes of immunosuppressant in current use, their modes of action and side effects. In addition, we highlight some of the complications arising from immunosuppression, and identify areas where further knowledge is needed.