New Nephro

Question 1

Basiliximab - MoA

Answer 1

IL2 receptor (anti CD25) on activated T cells
Used in induction solid organ for reduction in acute rejection

Question 2

Immunosuppression in solid organ Tx

Answer 2

Induction w/ Basilixiamb + triple Rx
- ATG: superior reduction in acute rejection in high immuno risk grps but w/ incr risk infections & malignancies EBV D+R- so usu steroid resistent rej, not 1st line

1. Pred
2. CNI (Tacro in Aus)
3. MMF (v Aza) - some sort of antimetabolite
4. m-TOR are now less common, use if issues w/ Ca or CMV but high S/E

Question 3

CNI in IS -Tac v Cyc

Answer 3

• Tac is superior for acute rejection & early graft loss
• Less de novo DSA (donor spec Ab)
• More DM, low Mg/PO3, tremor, neurotox
• Less gum hypertrophy, hirstutism, drug interactions

Question 4

Causes of AKI after CAG & how to differentiate

Answer 4

1. Contrast nephropathy
   (in pre-existing CKD & DM)
   starts 48hrs, baseline by 1wk
2. Cholesterol embolization
   - other signs including abdo pain & peripheral ischaemia, livedo reticularis
   - transient eisinophils
   - Usu 2-4wks after an event & persists >1wk