Immunosuppression Case Study

Patients who underwent this procedure had to remain on immunosuppressive drugs for about 6 months to prevent the recipient’s immune system from destroying the donor cell. One out of seven patients that had this procedure done had a relapse because they stopped taking their immunosuppressant drug during the critical stage of treatment. This treatment has proven successful, but there still remains the concern of tissue rejection and other complication. Nevertheless, this approach still provides encouragement for people suffering with the disease.

Problems can be caused via both types of adaptive immunity because they are frameworks made to help keep up homeostasis inside the body. Cytotoxic T cells are a piece of the cell-intervened kind of versatile resistance. When particular outside cells are identified in the body these cells become activated. Cytotoxic T cells specifically assault attacking antigens inside the body. Antibody-mediated immunity contains B cells that changes into plasma layer that integrates and secretes antibodies that bind to and deactivate particular antigens in the bodies fluids. An organ transplant cells for the most part is perceived in the body as non-self

However, there are side effects when taking this medication, such as: inflamed gums, acne, diarrhoea, increase in weight and abdominal pain. But this can be prevented by the doctor finding the best dosage to compact these side effects. Yet, there are other long term risks that arise from having a kidney transplant. Diabetes is one of them for the reason that people Feel a lot better and decide to eat more, causing a substantial increase in weight. Even certain kinds of immune-suppressants can develop the chance of diabetes. Another long term risk is high blood pressure because a lot of people who need this transplant already have an increased risk of obtaining high blood pressure and it does not help when taking immune-suppressants as it can make it worse. The other long term risk is cancer because the enduring use of immune-suppressants can increase different types of this condition, for example lymphoma (tumour in lymph node), skin cancer and “Kaposi’s sarcoma – a type of cancer that can affect both skin and internal organs” as mentioned by (NHS, 2014).

In order for transplants to be successful, there are steps that should be followed. From the beginning, the correct information should be given prior to

Feedback: The use of cyclosporine to protect the patient from rejection of the heart places the patient in an immunosuppressive state. The nurse should instruct on frequent

"We're advocates for the patient. We have no conflict of interest with the drug companies, and we're not against generics," said Dr. Flavio Vincenti, president of the American Society of Transplantation. Last September, Vincenti's medical specialist group filed a citizens' petition calling for more stringent FDA review of generic immunosuppressant drugs for transplant patients. And it has backed a wide range of state laws that would constrain generic substitution.

Immunosuppressants are a class of drugs that suppress, or reduce, the strength of the body’s immune system. Some of these drugs are used to make the body less likely to reject a transplanted organ. Other immunosuppressant drugs are often used to treat autoimmune disorders. With an autoimmune disease, the immune system attacks the body’s own tissue. Because immunosuppressant drugs weaken the immune system, they weaken this reaction. It helps reduce the impact on the body. Almost everyone who receives an organ transplant must take immunosuppressant drugs. This is because your immune system sees a transplanted organ as a threat. As a result your immune system attacks the organ as it would attack anything else. This can cause severe damage and lead to needing the organ removed. The drugs allow the transplanted organ to remain healthy and free from major damage. If you’re an organ recipient, even the slightest change from the medication regimen can trigger an organ rejection. All immunosuppressant drugs carry the serious risk of infection. It also means that any infections get will be harder to treat. (Immunosuppressant drugs,

When caring for our transplant patients that need to take Bactrim lifelong this less expensive than pentamidine. Pentamidine is very costly as it is scheduled monthly with a respiratory therapist. The treatment is on a nebulizer for about approximately an hour. The pharmacist removes Bactrim as an allergy. The pharmacists are important in offering different substitutions that are effective at achieving the needed result. Incomplete and duplicate orders are addressed with ordering physicians. “Coordination of care during the transition of care period plays an important role in the future of healthcare. Innovative strategies to improve care transition between acute care providers and outpatient primary care providers are essential to minimize patient risk for readmission” (Arnold, Buys, & Fullas,

Adverse reactions to this medication are migraine, speech disorders, rhinitis, sinusitis, hyperglycemia, elevated liver function, elevated serum creatinine level, pancytopenia, bronchitis, dyspnea, toxic epidermal necrolysis, anaphylaxis, elevated creatine kinase, generalized pain, and infection. Nursing considerations with this medication is to have the patient swallow the whole tablet and not to chew. Watch for aspiration while watching the patient take the medication. Educate the patient about the medication and inform them to notify a physician if bleeding

As with any transfusion reaction, it is imperative to comprehend the pathophysiology of this condition. There are two main mechanisms as to why TRALI can occur. There is an immune and a non immune mechanism of action. The immune mechanism is antibody mediated. It is believed that ninety percent of the time the antibodies originate in the donor blood product, and ten percent of the time the antibodies originate in the recipient. The antibodies are against HLA I, HLA II or HNA. Leukocyte antibodies can activate neutrophils directly, through anti HLA class I or anti HNA, or neutrophils can be activated indirectly by anti HLA class II . After being activated, either directly or indirectly, neutrophils release a neutrophil activating substance. Once other neutrophils are activated the produce reactive oxygen substances and release enzymes, such as elastase. Elastase causes the endothelium to become more permeable for plasma constituents, ultimately leading to pulmonary edema.

Although there are precautions taken to achieve the best match for organs, the human immune system is not so easily fooled into accepting a foreign organ. And that’s where drugs like rapamycin comes in. Antirejection medication are immunosuppressants which suppress the patient’s immune system so that it cannot attack the transported organ. Rapamycin is a drug that is prescribed to kidney transplant patients so their immune systems are weaken enough to not identify the newly transported kidney as foreign and reject it.

This drug is a reversible inhibitory of inosine monophosphate dehydrogenase (IMPD) and inhibits de novo purine synthesis, lymphocyte proliferation and antibody production. In dogs, its onset of action is rapid with maximal IMPD inhibition 2-4 hours post pill administration. It has a very similar action to azathioprine and can be used as an alternative since it seems to be less hepatotoxic and has very little myelosuppression effects comparatively. Common side effects of mycophenolate mofetil include gastrointestinal signs, predominately diarrhea but also vomiting and decrease in appetite. These side effects typically occur at higher doses (10-15mg/kg every 8 hours) and dose reduction and frequency seems to lessen the clinical side effects. However, as this drug is used more frequently, other side effects may become more

Azathioprine is used as a drug that is used to lower the body’s ability to reject a transplanted organ. It’s a chemotherapy drug now rarely used for chemotherapy, but more for immunosuppression in organ transplantation and autoimmune disease. This drug can lower blood cells that help your body fight infections. Some people using this drug have developed lymphoma (cancer).

This patient is mostly likely suffering from Post-transplant lymphoproliferative disorder, commonly called PTLD. Besides skin cancer, PTLD is one of the most common malignancies of post transplantation (LaCasce, 2006). Approximately 15% of transplant patients develop PTLD and it has a higher incidence amongst children than adults (DynaMed Plus, 2017) PTLD has a variety of presentations which lends to the difficulty and diversity of treatment options used for the disorder. The sites affected by PTLD and the incidence of the disorder depend its association with Epstein Barr virus and the transplant organ (LaCasce, 2006). The associated EBV infection is most commonly due to the donor graft and less commonly due to new environmental exposure

Siroimus -induced pneumonitis has also been reported. In contrast to CNIs, sirolimus is not associated with nephrotoxicity. Therefore, it can be used as an alternative immunosuppressive agent for transplant recipients who develop renal impairment with ciclosporin or tacrolimus therapy (Knechtle, 2014). Sirolimus is rapidly absorbed from the gastrointestinal tract following oral administration and reaches its peak concentration in 1-2 hours. After absorption, sirolimus is extensively bound to red blood cells and less than 5% of the drug remains free in the plasma. Sirolimus has a relatively low bioavailability (around 25%). It is metabolized in the liver and the intestinal wall by the CYP3A enzyme subfamily (CYP3A4 and CYP3A5) and to a minor extent by CYP2C8. Sirolimus has a long elimination half-life about 60 hours in renal transplant recipients. It has a narrow therapeutic index and theraputic drug monitoring of blood levels is essential to ensure safe and effective treatment (Knechtle,