TRANSPLANT DRUGS Reporter 15

Question 1

TYPES OF ORGAN TRANSPLANTATION

Cadaveric transplantation

Answer 1

a healthy organ donated at the time of a person’s death is transplanted into the body of
a patient with end-stage organ failure.

Question 2

TYPES OF ORGAN TRANSPLANTATION

Living-donor transplantation

Answer 2

a kidney or a portion of liver donated by a living person is transplanted into the body of
a patient with end-stage kidney or liver disease.

Question 3

Types of organ transplants:

AutografT

Answer 3

• is the transplant of tissue to the same person

Question 4

Types of organ transplants:

Allograft and allotransplantation

Answer 4

• is a transplant of an organ or tissue between
  two genetically non-identical members of the same species

Question 5

Types of organ transplants:

Isograft

Answer 5

subset of allografts in which organs or tissues are transplanted from a
donor to a genetically identical recipient (such as an identical twin).

Question 6

Types of organ transplants:
Xenograft and xenotransplantation

Answer 6

• a transplant of organs or tissue from one
  species to another

Question 7

Types of organ transplants:

Domino transplants

Answer 7

• in people with cystic fibrosis (CF), where both lungs need to
  be replaced, it is a technically easier operation with a higher rate of success to
  replace both the heart and lungs of the recipient with those of the donor

Question 8

Because very young children (generally under 12 months, but often as old as 24 months) do
not have a well-developed immune system, it is possible for them to receive organs from
otherwise incompatible donors. This is known as

Answer 8

ABO-incompatible (ABOi) transplantation

Question 9

ABO-incompatible transplants

The most important factors are that the recipient not have produced _____, and
that they have low levels of ____

Answer 9

isohemagglutinins

T cell-independent antigens

Question 10

The four types of hypersensitivity are:

Answer 10

Type I: reaction mediated by IgE antibodies
● Type II: cytotoxic reaction mediated by IgG or IgM antibodies
● Type III: reaction mediated by immune complexes
● Type IV: delayed reaction mediated by cellular response

Question 11

MEDICATION FOR INDUCTION THERAPY

. Basiliximab

Answer 11

I: kidney transplants
● Route: Parentera

Question 11

MEDICATIONS FOR MAINTENANCE THERAPY

Calcineurin Inhibitors

Answer 11

suppress the immune system by binding to cytoplasmic proteins that inhibit calcineurin
phosphatase

Question 11

MEDICATIONS FOR MAINTENANCE THERAPY

. Mammalian Target of Rapamycin Inhibitors

Answer 11

a. Sirolimus(Rapamune)

Question 11

. Calcineurin Inhibitors:

Answer 11

. Cyclosporine
b. Tacrolimus

Question 11

MEDICATIONS FOR MAINTENANCE THERAPY

Costimulation Blockers:

Answer 11

Belatacept

can affect your immune system
➢ may cause certain white blood cells to grow out of control
➢ may increase the risk for developing serious (even fatal) infections or certain
cancers
➢ AR: pale skin, lightheadedness, rapid heart rate, chest tightness, high/low
potassium, high blood sugar, or dangerously high blood pressure.

Question 12

.MEDICATIONS FOR MAINTENANCE THERAPY

Purine Antimetabolites

Answer 12

Azathioprine(Imuran, Thioprine)

➢ I: prevention of kidney transplant rejection
➢ drug half-life: 5 hours.
➢ Route: PO
➢ AR: increase risk of neoplasia, pancreatitis, abdominal pain, immunosuppression

Question 13

.MEDICATIONS FOR MAINTENANCE THERAPY

Inosine Monophosphate Dehydrogenase Inhibitors

Answer 13

Mycophenolate mofetil
➢ Blocks synthesis of purine nucleotides
➢ may inhibit recruitment of leukocytes to inflammatory sites
➢ Route: PO and IV

Question 14

.MEDICATIONS FOR MAINTENANCE ++THERAPY

6. Corticosteroids

Answer 14

Prednisone

Decreases inflammation by suppression of migration of polymorphonuclear
leukocytes and reversal of increased capillary permeability
➢ Suppresses the immune system by reducing activity and volume of the lymphatic
system
➢ Route: PO
➢ Long-term use may lead to: Impaired wound healing, Cushing syndrome,

Question 15

➢ is a polyclonal (depleting) antibody that blocks T- cell membrane proteins CD2, CD3, and
CD45

Answer 15

. Antithymocyte globulin (rabbit), or ATG rabbit

Question 16

➢ monoclonal antibody that binds specifically to the CD3 complex on the surface of T
lymphocytes;

Answer 16

Muromonab-CD3

Question 17

DRUGS FOR INFECTION

. Bacterial- Pneumocystis jiroveci pneumonia (PJP)
● Life threatening illness in immunocompromised patients

Answer 17

Routine prophylaxis with trimethoprim-sulfamethoxazole(TMP-SMZ) to reduce morbidity
and mortality of PJP following transplantation.

Question 17

DRUGS FOR INFECTION

Viral - most common to develop cytomegalovirus(CMV) plays role in organ rejection.

Answer 17

Patient must receive antiviral prophylaxis w/ oral ganciclovir (3-6months)
● If untreated can cause complications in the liver,kidney, heart,lungs and eyes.

Question 18

DRUGS FOR INFECTION

. Fungal-

Answer 18

• use Nystatin to treat thrush in the mouth and esophagus.