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

Abstract

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.