Table 3 Evolving low-toxicity maintenance immunosuppression regimens
Regimen | Comment |
|---|---|
Cyclosporine + azathioprine/MMF + steroids | Standard regimen. MMF preferred because it reduces incidence of acute rejection; significantly more expensive. Neoral replacing. Sandimmune in many centers. |
Tacrolimus + azathioprine + steroids | Alternative regimen to above |
Daclizumab/basiliximab + MMF + steroids | IL-2 receptor blockers used only in early post-transplant period but may obviate need for calcineurin inhibitor. |
Tacrolimus + MMF + steroids | Preliminary studies suggest very low incidence of acute rejection; gastrointestinal side effects are common but minimal steroid should reduce risk of diabetes mellitus. |
Sirolimus + cyclosporine + steroids | Sirolimus may allow greater reduction in cyclosporin or steroid doses. |