Table 3.

Evolving low-toxicity maintenance immunosuppression regimens

Regimen	Comment
Cyclosporine + azathioprine/MMF + steroids	Standard regimen. MMF preferred because it reduces incidence of acute rejection; significantly more expensive. Neoral replacing. Sandimmune in many centers.
Tacrolimus + azathioprine + steroids	Alternative regimen to above
Daclizumab/basiliximab + MMF + steroids	IL-2 receptor blockers used only in early post-transplant period but may obviate need for calcineurin inhibitor.
Tacrolimus + MMF + steroids	Preliminary studies suggest very low incidence of acute rejection; gastrointestinal side effects are common but minimal steroid should reduce risk of diabetes mellitus.
Sirolimus + cyclosporine + steroids	Sirolimus may allow greater reduction in cyclosporin or steroid doses.

IL, interleukin; MMF, mycophenolate mofetil.