renal transplant Flashcards
what do people usually receive post transplant?
mycophenalate
tacrolimus
steroids (but not in liverpool)
are tacrolimus brands interchangeable?
Not really
They shouldn’t be without extremely careful monitoring
what combination of meds to people receive after a transplant?
calcineurin inhibitor (tacrolimus) mycophenalate PPI's co-trimoxazole vanganciclovir
What do patients need for at least 6 months post transplant for PCP prophylaxis?
co-trimoxazole
Some patients may need TB prophylaxis
What would we give?
isoniazid
pyridoxine
what will a patient need if a CMV negative patient receives a CMV positive kidney?
valganciclovir prophylaxis
what will patients need of they receive a potent immunosuppresent alemtuzumab as there induction agent?
valganciclovir
only CMV negative to negative won’t require it
do all patients in CKD 5 needs transplant or dialysis
no
is sirolimus non-nephrotoxic?
yes
But rarely used and too weak immunosuppressant and delayed wound healing
how is basiliximab given?
infusion repeated after four days
how can alemtuzumab be given?
s/c injection
it can be given infusion but this is impractical out of hours
does renal transplant improve patients mortality and morbidity compared to dialysis?
yes
Did effects of tacrolimus
Extremely nephrotoxic if levels are allowed to rise too high Also cause cardiovascular problems Tremor Alopecia Hypomagnesia
Is MR tacrolimus favoured to standard BD formulation ?
No - more dips and troughs
Which monoclonal antibiotics need IV steroids, chlorphenamine and paracetamol before use ?
Alemtuzumab and rituximab
As these are stronger
Not basiliximab
