RENAL TRANSPLANT: Edited by Uwe HeemanDevelopments in immunosuppressionViklicky, Ondreja,b; Slatinska, Jankaa; Novotny, Mareka; Hruba, PetrabAuthor Information aDepartment of Nephrology, Transplant Center bTransplant Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic Correspondence to Ondrej Viklicky, MD, PhD, Professor of Medicine, Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 14021 Prague, Czech Republic. Tel: + 420 23605 4110; fax: +420 23605 3168; e-mail: [email protected] Current Opinion in Organ Transplantation: February 2021 - Volume 26 - Issue 1 - p 91-96 doi: 10.1097/MOT.0000000000000844 Buy Metrics Abstract Purpose of review In this review, we discuss achievements in immunosuppression in kidney transplant recipients published at last 18 months. Recent findings Results of recent trials with everolimus in low-risk primary kidney transplant recipients suggest that lowTAC/EVR combination is noninferior and CMV and BKV viral infections are less frequent to standTAC/MPA. Iscalimab monoclonal antibody, which prevents CD40 to CD154 binding, has just recently entered phase II clinical studies in kidney transplantation. Eculizumab, anti-C5 monoclonal antobody was recently shown to improve outcomes in DSA+ living-donor kidney transplant recipients requiring pretransplant desensitization because of crossmatch positivity. Proximal complement C1 inhibition in patients with antibody-mediated rejection was studied in several phase I trials. Summary Recent knowledge creates a path towards future immunosuppression success in sensitized recipients and in those in high risk of viral infections or CNI nephrotoxicity. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.