Abstract
Purpose of review In this review, we discuss achievements in immunosuppression in kidney transplant recipients published at last 18 months. Recent findings Results of recent trials with everolimus in low-risk primary kidney transplant recipients suggest that (low)TAC/EVR combination is noninferior and CMV and BKV viral infections are less frequent to (stand)TAC/MPA.
Iscalimab monoclonal antibody, which prevents CD40 to CD154 binding, has just recently entered phase II clinical studies in kidney transplantation. Eculizumab, anti-C5 monoclonal antobody was recently shown to improve outcomes in DSA+ living-donor kidney transplant recipients requiring pretransplant desensitization because of crossmatch positivity.
Proximal complement C1 inhibition in patients with antibody-mediated rejection was studied in several phase I trials. Recent knowledge creates a path towards future immunosuppression success in sensitized recipients and in those in high risk of viral infections or CNI nephrotoxicity.