Costimulation blockade:

Over the past several decades transplantation has emerged as the preferred form of therapy for endstage renal disease. Due to a host of factors, most notably improvements in immunosuppression, one-year allograft survival rates now exceed 90%. However, long-term success in transplantation is dependent upon rigid adherence to immunosuppressive regimens that require concomitant use of multiple agents. While graft survival rates have improved current immunosuppressive regimens are associated with significant toxicity that result in impairment of allograft function and other non-immune collateral toxicities which increase the risk of cardiovascular disease and early death. Furthermore, long-term allograft acceptance is dependent upon polypharmacy which is associated with extraordinary cost.