Emerging immunosuppressive drugs in kidney transplantation.

Calcineurin inhibitors (CNI), a cornerstone of current immunosuppressive therapy, have important cardiovascular and oncogenic side effects and CNI nephrotoxicity contributes to the multifactorial process called "chronic allograft dysfunction", the leading cause of chronic allograft failure among kidney transplant recipients. New drugs, with a different mechanism of action, are being developed focusing on a better balance between drug efficacy and toxicity. These novel compounds interfere with either T-cell mediated or antibody-mediated rejection. In this review, we report on the mechanism of action, pharmacokinetics and preliminary results of clinical trials of these promising new immunosuppressive drugs.