The field of immunosuppression has entered a new era of sophistication, enabling investigators to selectively target specific pathways within the immune system. Recent advances offer hope that rejection after transplantation may be prevented or treated more effectively than ever before.

Expanded understanding of the intracellular activities produced by immunotherapy provides a crucial foundation for clinical practice in transplant medicine. More than 25 drugs are currently under Investigation for treatment of rejection, with several already undergoing clinical trials.

Because they have limited actions, it is unlikely that any single agent ever will be able to control all components of the immune response. Advantages of combination therapy are, therefore, well established. Paramount to the success of this approach is the ability to select drugs with complementary mechanisms of action and without excess toxicities and unfavorable interactions. Mycophenolate mofetil (CellCept), a novel immunosuppressant for treatment of acute rejection after renal transplantation, holds great promise toward producing successful outcomes.

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