PMID- 33131123
OWN - NLM
STAT- MEDLINE
DCOM- 20210927
LR  - 20220122
IS  - 1875-9114 (Electronic)
IS  - 0277-0008 (Print)
IS  - 0277-0008 (Linking)
VI  - 41
IP  - 1
DP  - 2021 Jan
TI  - Immunosuppression trends in solid organ transplantation: The future of 
      individualization, monitoring, and management.
PG  - 119-131
LID - 10.1002/phar.2481 [doi]
AB  - Immunosuppression regimens used in solid organ transplant have evolved 
      significantly over the past 70 years in the United States. Early 
      immunosuppression and targets for allograft success were measured by incidence 
      and severity of allograft rejection and 1-year patient survival. The limited 
      number of agents, infancy of human leukocyte antigen (HLA) matching techniques 
      and lack of understanding of immunoreactivity limited the early development of 
      effective regimens. The 1980s and 1990s saw incredible advancements in these 
      areas, with acute rejection rates halving in a short span of time. However, the 
      constant struggle to achieve the optimal balance between under- and 
      overimmunosuppression is weaved throughout the history of transplant 
      immunosuppression. The aim of this paper is to discuss the different eras of 
      immunosuppression and highlight the important milestones that were achieved while 
      also discussing this in the context of rational agent selection and regimen 
      design. This discussion sets the stage for how we can achieve optimal long-term 
      outcomes during the next era of immunosuppression, which will move from universal 
      protocols to patient-specific optimization.
CI  - (c) 2020 Pharmacotherapy Publications, Inc.
FAU - Pilch, Nicole A
AU  - Pilch NA
AUID- ORCID: 0000-0003-4070-8946
AD  - Department of Pharmacy Practice and Outcomes Sciences, Medical University of 
      South Carolina, Charleston, South Carolina, USA.
FAU - Bowman, Lyndsey J
AU  - Bowman LJ
AD  - Department of Pharmacy, Tampa General Hospital, Tampa, Florida, USA.
FAU - Taber, David J
AU  - Taber DJ
AUID- ORCID: 0000-0001-7273-4589
AD  - Department of Surgery, Medical University of South Carolina, Charleston, South 
      Carolina, USA.
AD  - Department of Pharmacy Services, Ralph H. Johnson VAMC, Charleston, South 
      Carolina, USA.
LA  - eng
GR  - P30 DK123704/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Review
DEP - 20201230
PL  - United States
TA  - Pharmacotherapy
JT  - Pharmacotherapy
JID - 8111305
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Drug Monitoring
MH  - Forecasting
MH  - Graft Survival
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage/*therapeutic use
MH  - *Organ Transplantation
MH  - Randomized Controlled Trials as Topic
PMC - PMC8778961
MID - NIHMS1770088
OTO - NOTNLM
OT  - immunosuppression
OT  - solid
COIS- CONFLICT OF INTEREST L.J.B. is a member of the Speakers Bureau for Veloxis 
      Pharmaceuticals. All other authors declare no conflicts of interest.
EDAT- 2020/11/02 06:00
MHDA- 2021/09/28 06:00
PMCR- 2022/01/21
CRDT- 2020/11/01 20:44
PHST- 2020/07/15 00:00 [received]
PHST- 2020/08/07 00:00 [revised]
PHST- 2020/08/09 00:00 [accepted]
PHST- 2020/11/02 06:00 [pubmed]
PHST- 2021/09/28 06:00 [medline]
PHST- 2020/11/01 20:44 [entrez]
PHST- 2022/01/21 00:00 [pmc-release]
AID - 10.1002/phar.2481 [doi]
PST - ppublish
SO  - Pharmacotherapy. 2021 Jan;41(1):119-131. doi: 10.1002/phar.2481. Epub 2020 Dec 
      30.