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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Agents for induction of immunosuppression following lung transplantation

Agents for induction of immunosuppression following lung transplantation
Drug* Mechanism of action Suggested dose Monitoring Adverse effects Comments
Anti-thymocyte globulin Polyclonal antibody that causes nonspecific T cell depletion

Thymoglobulin (rabbit origin): 1.5 mg/kg over 6 hours, then two or three additional doses given 24 hours apart

Atgam (horse origin): 7.5 to 15 mg/kg per day for three to five days post transplant

Induction protocols may vary by institution		 Lymphocytes subsets Leukopenia, cytokine release syndrome, infusion reactions, thrombocytopenia, glomerulonephritis serum sickness Premedication includes glucocorticoids (eg, methylprednisolone 125 mg intravenously), antihistamines (eg, diphenhydramine 50 mg orally or intravenously), and antipyretics (eg, acetaminophen 1 g orally) one hour prior to infusion
Basiliximab Chimeric monoclonal antibody (25% mouse, 75% human antibody derived antibody) binds with high affinity to CD25 on T cells to inhibit IL-2 mediated T cell proliferation 20 mg on the day of transplantation and again on post-op day four N/A Low rate of adverse effects. Rarely: hypersensitivity, cytokine release syndrome. Most commonly used induction agent
Some agents that were previously used for induction immunosuppression in lung transplantation have limited or no availability, including alemtuzumab, daclizumab, and muromonab CD3.
* The US Food and Drug Administration has not approved any medications specifically for lung transplantation, so the doses are suggested based on the experience of large lung transplantation centers.
¶ Immunosuppressants may interact with BCG, live vaccines, and other agents that modulate the immune response, cause myelosuppression or agranulocytosis such as clozapine. For additional interactions, effects, and management suggestions, refer to Lexi-Interact drug interactions application included with UpToDate.
References:
  1. Bhorade SM, Stern E. Immunosuppression for lung transplantation. Proc Am Thorac Soc 2009; 6:47.
  2. Korom S, et al. Immunosuppressive therapy in lung transplantation: state of the art. Eur J Cardiothorac Surg 2009; 35:1045.
  3. Floreth T, Bhorade SM. Current trends in immunosuppression for lung transplantation. Semin Respir Crit Care Med 2010; 31:172.
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