Immunosuppression in Transplantation: Balancing Efficacy and Long-Term Outcomes

Authors

  • Rida Shakeel Dow Medical College Author
  • Sohaib Aftab Ahmad Chaudhry ABWA Medical College Author

DOI:

https://doi.org/10.63501/scennn60

Keywords:

Immunosuppression, Transplantation, Calcineurin inhibitors, Biologics, Long- term outcomes

Abstract

Background: Immunosuppressive therapy is critical for preventing graft rejection in transplant recipients, but long-term use is associated with significant complications, including infections and malignancies. 

Objectives: This narrative review evaluates the evolution of immunosuppressive strategies in transplantation, focusing on achieving a balance between efficacy and long-term patient safety. 

Methods: We reviewed clinical trials and observational studies from 2012 to 2024, focusing on calcineurin inhibitors, mTOR inhibitors, and novel biologics in renal and liver transplantation. 

Results: Modern protocols combining tacrolimus with mycophenolate mofetil have reduced acute rejection rates to below 10%. However, long-term use increases the risk of nephrotoxicity and infections by 25%. Emerging biologics, such as belatacept, show promise in reducing these risks but are limited by high costs and variable efficacy in high-risk patients. 

Conclusion: Tailored immunosuppression regimens that minimize toxicity while preventing rejection are essential for improving long-term outcomes. Future research should focus on personalized medicine approaches and the development of cost-effective biologics.  

References

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Published

2025-05-20

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⁠Review Article

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