Overview of transplantation immunology and the pharmacotherapy of adult solid organ transplant recipients: focus on immunosuppression

• Published in: AACN clinical issues Vol. 10; no. 2; p. 253
• Main Author: Bush, W W
• Format: Journal Article
• Language: English
• Published: United States 01.05.1999
• Subjects: Adult; Anti-Inflammatory Agents - therapeutic use; Azathioprine - therapeutic use; Cyclosporine - therapeutic use; Drug Interactions; Drug Monitoring - methods; Drug Monitoring - nursing; Graft Rejection - immunology; Graft Rejection - prevention & control; Humans; Immunosuppression - adverse effects; Immunosuppression - methods; Immunosuppression - nursing; Immunosuppressive Agents - therapeutic use; Muromonab-CD3 - therapeutic use; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - therapeutic use; Receptors, Interleukin-2 - antagonists & inhibitors; Steroids; Tacrolimus - therapeutic use; Transplantation Immunology
• ISSN: 1079-0713; 1538-9812
• DOI: 10.1097/00044067-199905000-00011

A review of transplantation immunology is discussed with emphasis on alloantigen presentation, T-lymphocyte activation and proliferation, and the immune effector mechanisms responsible for allograft rejection. Immunosuppressive pharmacology is introduced beginning with conventional medications (cyclosporine, azathioprine, and corticosteroids) followed by a discussion of drugs recently approved by the US Food and Drug Administration (mycophenolate mofetil, tacrolimus, and the interleukin-2 receptor antagonists). In addition, drugs that are used in the treatment of transplant rejection or as rescue therapy are discussed (muromonab-CD3, antithymocyte globulin, mycophenolate mofetil, tacrolimus, and corticosteroids). Throughout, implications for nurses involved in the pharmacotherapy of transplant recipients are discussed.