Chapter 12 Transplantation

Front 1

Type of rejection
rapid onset (in the OR)
preventable with blood matching and cross-match

Back 1

Hyper-acute rejection

Front 2

Type of rejection
T-cell mediated immunologic phenmenon
most likely to occur early post-transplant, but can occur any time post transplant if pt is not on adequate immunosuppression

Back 2

Acute rejection
tx with higher intensiy immunosuppression

Front 3

Type of rejection
long term complication
no adequate therapies to prevent /treat

Back 3

Chronic rejection
caused by immunologic mechanisms as well as inflammatory conditions

Front 4

Name the Immunosuppressant Classes

Back 4

1. Antibodies (thymo, simulect)
2.Corticosteriods
3.Calcineurin Inhibitors (tacrolimus, cyclosporine)
4. Antimetabolites (Imuran, cell cept, myfortic)
5.mTor inhibitors (sirolimus, everolimus)

Front 5

Name the drug:
-Polyclonal rabbit anti-thymocyte globulin,
-induction therapy,
-eliminates T-cells
-Adverse effects leukopenia, thrombocytopenia dose adjustment needed

Back 5

Thymoglobulin

Front 6

Name the drug:
-Chimeric anti-CD25 monoclonal antibody
-Blocks IL-2 receprot and prevents T-cell proliferation

Back 6

Simulect (Basiliximab)

Front 7

Name the drug:
-Inhibits production of IL-2 by helper T-cells
-Calcineurin Inhibitors
-Adverse effects: Nephrotoxicity, Neurotoxicity ect.

Back 7

Cyclosporine/ CsA/ Neoral

Front 8

Name the drug:
- maintenance Immunosuppressive agent
-inhibits calcineurin thus inhibiting both T-lymphocyte signal transduction and IL-2 transcription.
-lipophilic
-Adverse effects: Neurotoxicity ect.

Back 8

Tacrolimus/ FK/ Prograf

Front 9

Name the Drug
-Maintenance immunosuppression
-Inhibits DNA and RNA to prevent proliferation of T and B lymphocytes
-Adverse effects: leukopenia, throbocytopenia, pancreatitis
-Drug Interaction with Allopurinol

Back 9

Azathioprine (imuran)

Front 10

Name the Drug
-Maintenance immunosuppression
-Inhibits enzyme IMPDH in the de novo pathway of purine synthesis
-Prodrug
-Adverse effects: N/V/D

Back 10

Mycophenolate mofetil/ MMF/ Cell Cept

Front 11

Name the Drug
-Maintenance immunosuppression and treatment of acute rejection
-Impair transcription of IL-1, IL-2, IL-3, IL-6, and IFN-y genes
-Suppress antibody and complement binding
-Anti-inflammatory effects

Back 11

Corticosteriods (Prednisone and methylprednisolone)

Front 12

Name the Drug
-Maintenance immunosuppression
- Inhibits transduction of cytokine signal
-net effect is to inhibit T-cell response to IL-2
-do not cause a direct nephrotoxicity

Back 12

mTor Inhibitors: Sirolimus (Rapamune)
Everolimus (Zortress)
-impair wound healing