Flashcards in Solid Organ Transplantation Deck (78)
What is the average wait time for a kidney transplant?
4 years - long because we have dialysis
What is the average wait time for a liver transplant?
What is the average wait time for a heart transplant?
6 months- more critical
What are the 3 kinds of therapy associated with immunosuppression?
What is induction therapy?
an intense level of immunosuppression at time of transplant
- Can allow delay of nephrotoxic calcineurin inhibitors
What is maintenance therapy?
Highly individualized therapy
Can be reduced as risk for rejection decreases
What is rejection therapy?
Used to decrease immune response and prevent allograft damage
What are 4 induction therapy agents?
Anti-thrombocyte globulin (thymogobulin)
What is the brand name of anti-thrombocyte globulin?
What kind of antibody is thymoglobulin?
Depleting (depletes T cells)
What is the mechanism of thymoglobulin?
Binds to lymphocytes and causes lysis and depletion of lymphocytes
What kind of therapy is thymoglobulin used in?
induction and rejection treatment
What are some ADE of thymoglobulin?
What conditions require dose adjustment for thymoglobulin?
How do you prevent infusion site reactions?
pretreat with acetaminophen, diphenhydramine and steroids
-central line administration/slow infusion rate
What are some dosing/administration characteristics of thymoglobulin?
IV through central line
Requires 0.22 micron filter
1st dose over 6 hrs, rest over 4hrs
What is the brand name of alemtuzumab?
What is the mechanism of action of alemtuzumb?
Depletes both T and B lymphocytes by binding to CD52 and causing cell lysis
What is alemtuzumab's place in therapy?
transplant induction therapy and acute rejection therapy
How is alemtuzumab dosed?
Single dose at time of transplant (IV)
What are some ADEs of alemtuzumb?
Infusion related rxns- pretreat
What kind of antibody is alemtuzumab?
what kind of antibody is basilixumab?
non depleting antibody
What is the brand name of basilixumab
What is the mechanism of action of basilixumab?
IL-2 receptor antagonist by binding to CD25 on T lymphocytes and prevents IL-2 activation and proliferation of t cells.
Where is basilixumab's place in therapy?
What are some ADEs of basilixumab?
not associated with infusion related reactions
What are some dosing and administration characteristics of basilixumab?
2 doses IV, central or peripheral, over 30 min
What are 3 types of maintenance immunosuppressants?