In accordance with these three immune response profiles, the immunosuppressive therapy should be adapted to avoid organ rejection and reduce treatment side effects:
- Patients with a classical response (50%) should reduce their immunosuppressant treatment to the actual patient needs.
- Patients whose outcome is chronic rejection (40%) could be prevented by the early identification of this phenomenon and adjustment (increase/change) of immunosuppressive therapy.
- Patients showing an operational tolerance (10%) could be considered to gradually reduce or withdrawn immunosuppressive drugs, without compromising graft survival.
Accordingly, the main goal in organ transplantation is to identify the optimal immunosuppressant therapy to assure the effective prevention of rejection, while side effects are minimized.
However, currently there is no way to determine in an objective way the immune profile of patients that undergone a transplant, and the gradual reduction of mediations and evaluation of graft function along time is performed only based on empirical observations.
In one hand, patients at risk of chronic rejection or those developing any kind of operational tolerance could be at huge risk under this try and error approach, as it can lead to the irreversible organ rejection. So, majority of doctors do not recommend to withdrawn the medication even for patients suspicious of having developed operational tolerance and need objective tools to choose the best medication combo possible to treat an evolving rejection process.
On the other hand, for those patients with a classic immune response profile, side effects could be reduced significantly if a rational approach is used in the selection of the optimal treatment for the specific patient needs (personalized treatment).
For all of them, the previous determination of the effects of different drug combinations in the “immune response profile” of the patient and monitorization of the evolution along time, would led to rational and specific medication adjustments.