Immunosuppressants Used to Treat Transplant Rejection
Immunosuppressant | Mechanism of action | Indication | Main Adverse Effects |
|---|---|---|---|
Antilymphocyte globulin (ALG) | Inhibition of lymphocytes | Induction, maintenance, and treatment of acute rejection | Anaphylaxis, serum sickness, antigen-antibody–induced glomerulonephritis |
Inhibition of thymus cells | Induction, maintenance, and treatment of acute rejection | Anaphylaxis, serum sickness, antigen-antibody–induced glomerulonephritis | |
Purine metabolism inhibitor | Maintenance | Myelosuppression, hepatitis | |
Inhibition of T-cell proliferation by blocking the effect of IL-2 | Mostly induction | Infection, anaphylaxis, myeloproliferative disorders | |
Antibody that inhibits T-cell costimulatory pathways | Maintenance | Progressive multifocal leukoencephalopathy, other viral infections | |
Corticosteroids | Anti-inflammatory | Induction, maintenance, and adjunctive treatment of acute rejection | Diabetes, hypertension, osteoporosis, atherosclerosis |
Calcineurin inhibition (blocking T-cell transcription) | Induction (rarely), maintenance, and treatment of acute and chronic rejection | Nephrotoxicity, neurotoxicity, hyperlipidemia, hirsutism, hypertrichosis, diabetes, hepatotoxicity, tophaceous gout, refractory hypertension, increased incidence of other tumors, gum hypertrophy | |
Inhibition of mammalian target of rapamycin (mTOR), inhibiting lymphocyte response to cytokine stimulation | Maintenance | Interstitial pneumonitis, leg edema, hyperlipidemia, impaired wound healing, bone marrow depression | |
Purine metabolism inhibitor | Maintenance | Myelosuppression, nausea, vomiting, diarrhea | |
Inhibition of mammalian target of rapamycin (mTOR), inhibiting lymphocyte response to cytokine stimulation | Maintenance | Interstitial pneumonitis, leg edema, hyperlipidemia, impaired wound healing, bone marrow depression | |
Calcineurin inhibition (blocking T-cell transcription) | Induction, maintenance, and treatment of acute and chronic rejection | Nephrotoxicity, neurotoxicity, hyperlipidemia, alopecia, hypertension |