Timeline for Important Immunosuppressants

As Mrs. Q has stated in a comment on an earlier post, the field of medicine has advanced rapidly in the past several decades and as new technologies and techniques were being discovered and perfected the margin for error has slowly decreased until it reached the accuracy we have today. The first truly successful kidney transplant didn’t occur until 1954 and was done between two identical twins, thus no immunosuppressive treatment was given or needed. Between 1954 and the present, many other kidney transplants were necessary, but early on, not many were attempted as the outcome would most surely be acute rejection unless the graft came from an identical twin (even then, mutations have a chance of affecting the expression of protein markers). It wasn’t until 1957, that the first widely used induction therapy agent Imuran, was used. With it came an incredible amount of side effects, the most severe being an increased chance of developing T cell cancer. From then until 1971, we did not know that the BK virus even existed, nor did we know of its detrimental effects on kidney grafts. Reliable detection would not come until 1983 and wouldn’t be perfected for another few years after this date. Because of this data from the before 1985 is very unreliable.

Another important factor which affects the reliability of the data was the immunosuppressive agents available and how widespread their usage was. It is for this reason that I have included at the end of this post a timeline with the year that important induction and maintenance agents were first synthesized, and for many when their usage became widespread.

eATG-- started in 1970, fully established by 1980 (Equine Anti-thymocyte Globulin)

rATG-- started 1980, fully established by 1990 (Rabbit Anti-thymocyte Globulin)

OKT 3-- 1985

Campath-- 2000

Basiliximab--1998

Daclizumab--1997

Imuran-- 1957

Celcept-- 1995

Cyclosporine-- 1983

Prograf-- 1994