Abstract

IMMUNOSUPPRESSANTS THERAPY IN KIDNEY TRANSPLANTATION: A COMPRESSIVE REVIEW

Kirti Pandav*, Dr. Karishma Nikose, Samiksha Thaware, Achal Mandale, Siddhesh Lande

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Abstract

Kidney transplantation remains the most effective treatment for patients with end-stage renal disease (ESRD), offering superior survival, enhanced quality of life, and reduced long-term healthcare costs compared to dialysis. The success of transplantation depends largely on the effectiveness of immunosuppressive therapy, which prevents graft rejection by modulating the recipient’s immune response. Modern immunosuppressive regimens employ a combination of agents targeting distinct immune pathways, allowing synergistic efficacy with minimized toxicity. The principal drug classes include calcineurin inhibitors (cyclosporine, tacrolimus), antiproliferative agents (mycophenolate mofetil, azathioprine), corticosteroids, and mammalian target of rapamycin (mTOR) inhibitors (sirolimus, everolimus). These agents suppress T-cell activation, cytokine production, and lymphocyte proliferation—key steps in immune-mediated graft rejection. Despite substantial advances, long-term challenges such as nephrotoxicity, infection, metabolic complications, and chronic allograft dysfunction persist. Continued research into individualized therapy, biomarker-guided dosing, and novel immunomodulatory agents promises to improve graft survival and patient outcomes. This review highlights the mechanisms, therapeutic roles, dosing strategies, and clinical considerations of the major immunosuppressive agents used in kidney transplantation.

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