>> Your immune system protects you by fighting infections and foreign bodies.
Your immune system will recognize a newly transplanted organ
as a foreign body, and will fight against it.
Medications called immunosuppressive drugs are used to prevent your body
from rejecting your newly transplanted organ.
You will need to take immunosuppressive medications for your lifetime.
These medications are very expensive, costing between 2,000 and 4,000 dollars every month.
You will need to work with your financial coordinator to develop a sound insurance
and financial plan to cover the cost of these medications.
As a transplant recipient, you will begin taking new medications the day of
or the day after your transplant.
You will take medications to prevent rejection,
to prevent infection, and other medications as well.
You will need to take some combination of medications for the remainder of your life,
or your transplanted organ will fail.
All medications have possible side effects.
Here is a list of side effects associated with your transplant medications.
You are not likely to have all the side effects, or have them all at a high intensity.
If you have any concerns about your side effects,
you should discuss your concerns with your transplant nurse.
Many of the medications must be tapered, or slowly reduced.
Do not independently withdraw from taking any medication.
Discuss any concerns you have with your transplant nurse or physician.
To prevent rejections, you will take a combination of three medications
after surgery -- Prednisone, which is a steroid; azathioprine, also known as Imuran;
or mycophenolic, also known as CellCept; tacrolimus, or cyclosporine.
The exact combination of these drugs will be determined by the transplant team.
Due to their anti-inflammatory and immunosuppressive properties,
steroids have been the main component in the immunosuppressive regimen for the prevention
and treatment of acute rejection after lung transplantation.
Prolonged exposure to steroids result in significant side effects,
which include worsening cholesterol levels and high blood pressure,
the development of post-transplant diabetes mellitus, weight gain, and osteoporosis.
Our standard protocol is designed to minimize these effects,
by keeping the maintenance steroid dosage low.
Azathioprine, or Imuran, mycophenolic, mofatile, or CellCept, and mycophenolate sodium,
or myfortic, are medications used in combination with tacrolimus or cyclosporine.
Azathioprine is known to cause liver function abnormalities,
low blood counts, and pancreatitis.
The main toxicities of mycophenolate are upset stomach and diarrhea.
Cyclosporine and tacrolimus can cause abnormal kidney function,
high blood sugar, tremors, and headaches.
These medications could cause serious harm to a fetus if taken while pregnant.
Therefore, women of child-bearing ages should avoid pregnancy for the rest of their lives.
If you have any questions regarding these medications, or pregnancy,
please discuss it with your transplant coordinator or physician.
Anti-fungal and anti-viral medications are administered
to prevent infection after transplant.
These are very expensive medications, each one costing approximately 2,000 dollars a month.
These medications are usually covered by insurance, but carry high co-pays.
Because of the side effects of your transplant medications,
you may require additional medications to treat high blood pressure and high blood sugar.
Do not take any non-steroidal anti-inflammatory drugs or NSAIDs.
These include Aleve, Advil, Motrin, or Ibuprofen.
These medications are too hard on your kidneys, and should be avoided.
Avoid eating grapefruits and drinking grapefruit juice, due to numerous interactions
with your transplant medications.
Do not go to the dentist for six months after your transplant operation.
To reduce the risk of developing an infection,
you will need to take an antibiotic before any dental work is done,
including routine cleanings.
You must learn about each of your new medications before you can be discharged
from the hospital.
You will need to know the drug name, the purpose of the medication, the side effects,
and the dosages of each medication.
The nursing staff will work with you and your care giver
to develop a self-medication schedule.
Your support person must participate in learning about your medications.
To ensure you can safely manage your own medications at home,
you and your support person will be quizzed to demonstrate your knowledge
about your medications prior to discharge.
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