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People who have had an organ transplant need antirejection medicines, or immunosuppressants. This is because your
immune system will try to destroy the new organ. These medicines weaken your immune system and
decrease your body's ability to destroy your new organ. But they also decrease your body's ability to fight infections, cancer, and other diseases.
Here are some of the medicines you may need to take. You may have to take other medicines to prevent infection or to control other health problems you have (like high blood pressure).
high dose of a corticosteroid is given right before
your transplant. It decreases your immune system's activity, reduces
inflammation, and prevents rejection. A high dose is usually continued for a few days after your surgery. Then the dosage is slowly reduced to the lowest dose that helps prevent rejection.
Taking high doses
of corticosteroids for just a few days may cause temporary side effects such as
high blood pressure, high cholesterol, weight gain, sleep problems, and
anxiety. High doses can sometimes cause more severe side effects, such as
extreme agitation, paranoia,
psychosis, and hallucinations.
Using corticosteroids for a long time can
glaucoma or steroid-induced
Corticosteroids include prednisone or methylprednisolone.
These medicines block the message that causes rejection. You
probably will always need to take calcineurin inhibitors.
Side effects include high blood
pressure, too much potassium in the blood (hyperkalemia), and kidney problems.
These medicines can also cause nausea, vomiting, diarrhea, high cholesterol,
Calcineurin inhibitors include tacrolimus and cyclosporine.
These medicines prevent the immune cells
from multiplying and prevent your immune system from
attacking and destroying the donor organ.
Common side effects can include
nausea, anemia, high
triglycerides, and intestinal upset.
Antiproliferative agents include mycophenolate mofetil,
azathioprine, and sirolimus.
These antibodies block the growth of immune cells that are responsible for rejection. They are used early after transplantation along with
calcineurin inhibitors and antiproliferative agents.
Monoclonal antibodies include daclizumab, basiliximab, and rituximab.
These medicines temporarily deplete
the body's immune cells. They are used in the hours and days
immediately after your organ transplant to prevent your body from rejecting the
donor organ. They may also be used again if your body starts to reject the
They are often used to reduce early use of calcineurin inhibitors,
which can have serious side effects. Side effects of polyclonal antibodies
include fever, itching, and joint pain.
Polyclonal antibodies include antithymocyte globulin-equine
and antithymocyte globulin-rabbit.
May 18, 2012
E. Gregory Thompson, MD - Internal Medicine & Anne C. Poinier, MD - Internal Medicine
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