New agents, new ideas and new

The year 2011 was marked by the addi-tion of an important alternative to calci-neurin inhibitors for immunosuppression in kidney transplantation. Calcineurin inhibitor-based combina tions are the most frequently utilized immunosuppressive regimens in kidney transplantation, but they carry a metabolic burden and may be associated with both short-term and possibly progressive diminution in graft function. Belatacept is a costimulation blocker that binds to CD80 and CD86 on antigen-presenting cells and provides effective immunosuppression while being devoid of renal and nonrenal metabolic adverse effects.