Can the Early Elimination of Calcineurin Inhibitors Result in Clinical Benefits?

Ideally, every kidney should serve its owner for his or her remaining life expectancy. Current approaches with immunosuppression have steadily reduced early rejection rates. However, we have not seen a comparable improvement in graft longevity. Reduction of acute rejection rates should improve survival, unless concurrent nephrotoxicity offsets this benefit. An important question is whether selective substitution of other drugs/biologicals for calcineurin inhibitors will permit adequate immunoprophylaxis, yet improve graft longevity.