1. Jorge L. Posada, MD University of Puerto Rico School of Medicine Assistant Professor of Internal Medicine Nephrology Fellow 4/17/08

4. Anatomy of Renal Transplantation

7. Life Expectancy Ojo, J Am Soc Neph , 2001;12:589

8. Cardiovascular Benefits Foley, Am J Kidney Dis , 1998;32(S1):8 Slide courtesy of Dr. Robert Gaston

11. Immunosuppressive Medications Slide courtesy of Dr. Meier-Kriesche

12. Three-Signal Model Halloran, N Eng J Med , 2004;351:3715

16. Halloran, N Eng J Med , 2004;351:3715

21. Halloran, N Eng J Med , 2004;351:3715

23. Calcineurin Inhibitors: Mechanism of Action CsA: Cyclosporine FK506: Tacrolimus FKBP: FK Binding Protein CpN: Cyclophilin NF-AT: Nuclear Factor of Activated T-cells (c- cytosolic component; n- nuclear component). Stepkowski, Expert Rev Mol Med , 2000;2(4):1

24. Halloran, N Eng J Med , 2004;351:3715

26. Calcineurin Inhibitors: Interactions Halloran, from Johnson (ed.), Comprehensive Clinical Nephrology , Mosby Elsevier, 2003.

30. Calcineurin Inhibitors: Adverse Effects Adapted from Danovitch, Handbook of Kidney Transplantation , Lippincott Williams & Wilkins, 2005 Cyclosporine Tacrolimus Hypertension ++ + Pancreatic islet toxicity + ++ Neurotoxicity + ++ Hirsutism + - Hair loss - + Gum hypertrophy + - GI side effects - + Gastric motility - + Dyslipidemia + - Hyperuricemia ++ + ↑ K + /↓Mg 2+ + +

32. Sirolimus: Mechanism of Action SRL: Sirolimus FKBP: FK Binding Protein mTOR: Mammalian target of rapamycin Cdk: cyclin-dependent kinase Stepkowski, Expert Rev Mol Med , 2000;2(4):1

33. Halloran, N Eng J Med , 2004;351:3715

36. Mechanism of Action: MPA Prodrugs Stepkowski, Expert Rev Mol Med , 2000;2(4):1

37. Halloran, N Eng J Med , 2004;351:3715

48. Banff ‘05 Classification Solez, Am J Transplant , 2007;7:518

54. BK Virus Monitoring Algorithm Randhawa, Brennan, Am J Transplant , 2006;6:2000