Abstract
Immunosuppressive drugs are now widely used as preventive treatments of allograft rejection in organ transplantation. Monitoring of drug concentration reduces the frequency of acute graft rejection but over 10% of renal transplant recipients experience at least one acute rejection within the first 6 months after transplantation. In addition, drug toxicity, especially due to over immunosuppression seriously hamper long-term success. For further optimization of immunesuppressive therapy, new monitoring strategy is required and pharmacodynamics strategies could constitute novel approaches for optimization of immunosuppressive drugs. In this review I summarized those trials mainly based on our own studies and proposed useful biomarkers including drug target cytokines and lymphocyte proliferation.The studies show that the degree of immunosuppression can be quantitated in each transplant recipient. Future prospective studies will confirm the potentiality of these markers toward optimized individually-tailored immunosuppressive treatment. In addition, these biomarkers could be also helpful for weaning or minimization of immunosuppressive therapy and the selection of the treatment candidates.
