Download Post Transplant Immune Suppression

Post Transplant
Immune Suppression
Lung Transplant Education Series
Valerie Durney, NP, CCTC
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OVERVIEW

Why do I need these medications?

Which of my medications suppress my immune system?

What are common side effects of these medications?

What symptoms should I be aware of?

What are important things to know about these pills?
Post Transplant Immune Suppression
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
After lung transplant your immune system needs to be altered to
prevent rejection or your own body trying to fight the new lung(s)

Ideally, your body will become tolerant to the new lung
Post Transplant Immune Suppression
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
We achieve this goal with the medications you are prescribed, they
work in combination to suppress your immune system

It is extremely important to take your medications as directed

Once you are home develop a system to ensure you take your
medications on time
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
The transplant team will monitor your blood levels to achieve the
most appropriate level of immune suppression for you

This may place you at risk for catching illnesses from others
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PRECAUTIONS

Precautions need to be instituted
at home to help prevent the
spread of infection
Good hand-washing is the #1
precaution in stopping the spread
of infection
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WHICH OF MY MEDICATIONS
SUPPRESS MY IMMUNE SYSTEM
Prograf
CellCept
Prednisone
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PROGRAF

Most important medication!

Needs to be taken every 12
hours

Interacts with many
medications
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PROGRAF: COMMON SIDE EFFECTS






Tremors
Headache
GI: Nausea/diarrhea
Kidney problems
Low magnesium
Elevated blood sugars
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PROGRAF
Formulations: 0.5mg, 1mg & 5mg capsules


BRAND NAME NECESSARY
Acceptable alternative to Prograf is: Hecoria
(this a newer brand name medication)
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PROGRAF

We will check blood levels of Prograf to ensure your level is within a
target range

Blood levels need to be a 12 hour trough-this means your blood is
drawn 12 hours after your last dose

Please eat/drink as usual prior to your clinic labs as you do NOT
have to be fasting
Post Transplant Immune Suppression
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PROGRAF

You can take your AM Prograf dose after your blood is drawn
Please avoid grapefruit juice, as this can elevate your blood
level of Prograf
Post Transplant Immune Suppression
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CELLCEPT

Formulations: 250 & 500mg capsules

Taken every 12 hours

Important to take with food

Should be separated from antacids

Generic Ok
Alternative to CellCept is Myfortic. This is
enteric coated CellCept
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CELLCEPT: COMMON SIDE EFFECTS

Nausea/vomiting

Diarrhea

Low blood counts

*Pregnancy concerns*
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PREDNISONE

Tapered dosing over the first 4
months after transplant

Goal dose = 5mg

Taken every morning

Generic Ok
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PREDNISONE: COMMON SIDE
EFFECTS




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

Elevated blood sugars
Elevated blood pressure
Weight gain
Puffy face
Insomnia
Irritability/moodiness
Bone weakness/osteoporosis
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GENERAL TIPS

Keep out of reach of children

Check with transplant team before starting a new medication
prescribed from another provider

Always swallow capsules whole and never chew/crush or open
capsules
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GENERAL TIPS
1.
Purchase a pill box to keep organized
2.
Consider setting an alarm to avoid forgetting doses
3.
Discuss with transplant team any concerns about side effects to
medications
4.
Avoid herbal supplements
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GENERAL TIPS

Always keep an up to date
medication list with you at all
times

Plan ahead for refills!

Please purchase a medical
alert bracelet in case of
emergencies that states you
are a transplant patient and
keep a list of your medications
in your wallet
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Post Transplant Immune Suppression
Always contact your transplant coordinator
for with any questions or concerns!
Linda: 617-732-7299 (last names starting with A-K)
Betsy: 617-732-5971 (last names starting with L-Z)
or via Patient Gateway
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REFERENCES

Transplantation Drug Manual, 5th Edition

J. Pirsch, H. Sollinger, X. Liang

Landes Bioscience

Austin, TX USA


Transplantliving.org
BWH: A Guide To The Care of Lung Transplant Recipients At BWH
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