Kidney Transplant Flashcards
Steps of immunosuppression in kidney transplant
Induction- stuns immune system
Maintenance- light reign on immune system
Antirejection- spank system back in line
Anti-IL-2 receptors Antibodies (2)
Dacluzimab and Basiliximab
What do calcinurin inhibitors do?
block IL-2 production
What are the 2 main categories of calcinurin inhibitors?
Cyclosporin and Tacrolimus
What steroids are used for immunosuppression?
Methylprednisoloine, prednisone
What do antimetabolites do?
inhibits de novo purine synthesis
What are the 3 main antimetabolites?
Azathioprine, mycophenolate mofetil, mycophenolic acid
What types of drugs are used in induction?
Antibodies and methylprednisolone
What types of drugs are used in maintenance?
Calcinurin inhibitors, steroids, antimetabolites, mTOR inhibitors, Belatacept
What are the main mTOR inhibitors?
Sirolimus, Everolimus
What is Belatacept?
Fusion protein of IgG1 and the extracellular domain of CTLA-4
Blocks co-stimulation of T cells by preventing CD28-CD80/86 interaction
What are the two approaches to anti-rejection therapy?
Preventing cell-mediated rejection and antibody-mediated rejection
What can be used to prevent cell mediated rejection?
pulse steroids and thymoglobulin
What can be used to prevent antibody-mediated rejection?
rituximab, plasmapheresis, IVIg
SEs of Antibodies
Lymphopenia, cytokine release syndrome
SEs of steroids
weight gain, glucose intolerance, hyperlipidemia, hypertension, osteoporosis, avascular necrosis, cataracts
SEs of Calcinurin inhibitors
nephrotoxicity, gingival hyperplasia, hypertrichosis, hyperlipidemia, tremor, neuropathy, hyerpuricemia/gout, glucose intolerance, HUS
SEs of azathioprine
leukopenia/myelosuppression, hepatotoxicity, pancreatic toxicity, interactions with allopurinol
SEs of mycophenolate
GI intolerance, leukopenia/myelosuppression
SEs of sirolimus
hyperlipidemia, impaired wound healing, interstitial pneumonitis
