Chapter 56: Transplant Flashcards
Prior to any transplant, tissue typing or crossmatching is performed to assess donor-recipient compatibility for
HLA and ABO blood group
Transplant of an organ or tissue from one individual to another
allograft
Transplant from a genetically identical donor (such as an identical twin) is called
isograft
Transplant in the same patient, from one site to another (e.g., stem cell or skin grafting)
Autograft
_____ immunosuppression is given before or at the time of transplant to ______
Induction
to prevent acute rejection during the early post-transplant period
Most commonly used induction drug
Basiliximab
Basiliximab drug class
IL-2 receptor antagonist
Patients at higher risk of rejection can receive which drug class
antithymocyte globulin
antithymocyte globulins can be used for which stages of transplant
induction and treatment or rejection
antithymocyte globulin brand names
Atgam (equine)
Thymoglobulin (rabbit)
antithymocyte globulin MOA
binds to T-lymphocytes and interferes with their function
antithymocyte globulin boxed warning
anaphylaxis
antithymocyte globulin side effects
infusion-related reactions (premedicate)
What is the first line calcineurin inhibitor (CNI)
Tacrolimus
What is the first line antiproliferative agent
Mycophenolate
Suppressing the immune system via multiple mechanisms through different drug classes has what 2 benefits
lowers toxicity risk of individual immunosuppressants and reduces risk of graft rejection
Mycophenolate mofetil brand name
CellCept
Mycophenolic acid brand name
Myfortic
Mycophenolate boxed warnings
Increased risk of infection, increased development of lymphoma and skin malignancies, increased risk of congenital malformations and spontaneous abortions when used during pregnancy
Mycophenolate side effects
Diarrhea, GI upset
T/F: CellCept and Myfortic are NOT interchangeable
True
Which brand of mycophenolate is enteric coated to decrease diarrhea
Myfortic
CellCept IV is stable in ____ only
D5W
Mycophenolate decreases efficacy of
oral contraceptives
Azathioprine warning
Patients with genetic deficiency of TMPT are at high risk for myelosuppression and may require lower dose
Tacrolimus drug class
Calcineurin inhibitor
Tacrolimus brand name
Prograf
Tacrolimus MOA
inhibits T-lymphocyte activation
Tacrolimus boxed warnings
Increased susceptibility to infection, possible development of lymphoma