Pirfenidone: A Novel Potential Therapeutic Agent in the Management of Chronic Allograft Rejection

Chronic allograft dysfunction is a leading cause of allograft failure, morbidity, and mortality after solid organ transplantation. The pathogenesis of chronic allograft failure has a final common pathway leading to organ fibrosis. Pirfenidone is an effective and novel antifibrotic agent with anti-inflammatory properties. Clinical use of the agent has been tested in a number of nontransplant recipients and has a favorable safety profile based on available clinical data. Building on these observations and findings, and considering the role of fibrosis in chronic allograft rejection, pirfenidone was initially investigated as adjunct therapy in a rat heterotopic tracheal transplantation model. This led to several studies confirming that pirfenidone may well be worth considering for further investigation. This paper reviews the possibility of using pirfenidone in clinical transplantation management.