Immunosuppressants solid organ transplant

Solid organ transplant recipients have a blunted immune response to vaccines because the immunosuppressive regimens used to prevent organ rejection inhibit both T- and B-cell proliferation. Many of these patients will also have secondary hypogammaglobulinemia post-transplantation. Prior to transplant, children should complete primary immunization schedules if possible accelerated schedules may be used. Adults should have all vaccinations updated prior to transplantation.16... 

A patient developed atorvastatin-induced severe autoimmune hepatitis and a lupus-like syndrome. Although the drug was immediately withdrawn, the disease persisted and deteriorated to a fulminant form with acute hepatic failure. There was no response to conventional immunosuppression with glucocorticoids and azathioprine. Only the introduction of intense immunosuppressive therapy, as used in solid organ transplantation, led to a complete and sustained recovery. The patient had the HLA haplotypcs DR3 and DR4, which are well-known genetic factors associated with autoimmune diseases. 

Braun F, Behrend M. Basic immunosuppressive drugs outside solid organ transplantation. Expert Opin Inves-tig Drugs. 2006 15 267—291. 

Taylor AL, Watson CJ, Bradley JA. Immunosuppressive agents in solid organ transplantation mechanisms of action and therapeutic efficacy. Crit Rev Oncol Hematol. 2005 56 23-46. 

Dunn, D. L. (1990). Problems related to immunosuppression. Infection and malignancy occurring after solid organ transplantation.Crit. Care Clin. 6, 955-977. 

What immunosuppressive drugs are used to prevent allograft rejection in solid organ transplantation ... 

Ganciclovir therapy (5 mg/kg every 12 hours for 14 to 21 days) may benefit other CMV syndromes in AIDS patients or solid-organ-transplant recipients. Response rates of 67% or higher have been found in combination with a decrease in immunosuppressive therapy. The duration of therapy depends on demonstrating clearance of viremia an early switch from intravenous ganciclovir to oral valganciclovir is feasible. Recurrent CMV disease occurs commonly after initial treatment. In bone marrow transplant... 

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