Report of the First World Transplant Congress

During the past 20 yr, new immunosuppressant medications that reduced the rate of acute rejection became available for transplantation. Long-term survival of transplanted organs, however, did not improve to the extent predicted. Chronic immunosuppression is associated with cardiovascular, metabolic, and renal toxicities that negatively affect patient and graft survival. Therefore, there is a pressing need for new approaches to immunosuppression that might better prevent acute rejection with a safety profile that is superior to current regimens. Moreover, the performance of currently available agents should be largely ameliorated by optimizing drug combinations and dosages. The latter goal can be achieved only through the development of specific immune markers of over- and underimmunosuppression to help tailor the immunosuppressive regimen for individual patients and even to allow safe withdrawal of immunosuppression in selected patients. Recent research has resulted in the discovery of new pathways of alloimmune reactivity, thereby offering novel immunologic targets for more specific and minimally toxic antirejection therapies. Finally, recent achievements pushed transplant medicine forward toward its ultimate goal of achieving a condition of tolerance for allogeneic antigens that prevents acute rejection without maintenance immunosuppression. All of these topics were addressed in the more than 3000 abstracts that were presented at the World Transplant Congress, held in Boston July 22 through 27, 2006.