Transplant Medications and Their Side Effects
To prevent rejection, patients receive immunosuppressants (drugs that suppress the immune system) so that the new organ(s) is not damaged. Because rejection can occur anytime after a transplant, immunosuppressive drugs are given to patients the day before their transplant and thereafter for the rest of their lives. To avoid complications, patients must strictly adhere to their drug regimen. The three main drugs now being used are cyclosporine, azathioprine, and prednisone. Researchers are working on safer, more effective immunosuppressants for future testing. Some of the more promising drugs are FK-506 and mycophenolate mofetil.
Doctors must balance the dose of immunosuppressive drugs so that a patient's transplanted organ(s) is protected, but his or her immune system is not completely shut down. Without an active enough immune system, a patient can easily develop severe infections. For this reason, medications are also prescribed to fight any infections.
To carefully monitor transplant patients for signs of heart rejection, small pieces of the transplanted organ are removed for inspection under a microscope. Called a biopsy, this procedure involves advancing a thin tube called a catheter through a vein to the heart. At the end of the catheter is a bioptome, a tiny instrument used to snip off a piece of tissue. If the biopsy shows damaged cells, the dose and kind of immunosuppressive drug may be changed. Biopsies of the heart muscle are usually performed weekly for the first 3 to 6 weeks after surgery, then every 3 months for the first year and yearly thereafter.
This information is adapted from the NHLBI Information Center, a service of the NHLBI and the National Institutes of Health. The Information Center provides information to health professionals, patients, and the public about the treatment, diagnosis, and prevention of heart, lung and blood diseases.
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