The therapy itself is designed to suppress unwanted immune responses to stimuli.
Often this technology is used to get rid of autoimmune diseases - these are pathologies during which the immune system suffers greatly, the body is attacked and its own organs are destroyed. Read more about the definition of anti-inflammatory and immunosuppressive therapy in rheumatological diseases and kidney disease - further.
What is this?
You can often hear that during transplantation, immunosuppressive therapy is used, it is necessary in order to prevent possible attacks of rejection of an organ that was transplanted from another organism. It is also widely used after bone marrow transplantation. Such treatment is extremely important in order to fulfill the prevention of the disease, as well as during the acute phase.
Complications
There are andchronic graft reactions to a new host, otherwise called complications of immunosuppressive therapy for glomerulonephritis. This is due to the fact that it is the donor system that begins to negatively affect the patient's body. Unfortunately, immunosuppressive therapy entails negative consequences, increases the risk of an infectious disease, which is why this technique should be combined with other measures that are designed to reduce the risk of infection.
Treatment
Specific immunosuppressive therapy has at its disposal cytostatics, glucocorticoids. These drugs are secondary, like Sirolimus, Tacrolimus and others. In parallel, other means are used, such as monoclonal antibodies. They are designed to get rid of negative influences at a certain cellular level in the immune system.
Maintenance immunosuppression
There are a lot of indications for immunosuppressive therapy in glomerulonephritis. But the main thing is the following: this procedure should provide the longest possible life expectancy with the transplant that was placed in the human body. And this, in turn, is a decisive and, at the same time, adequate suppression of immunity at the time of risk. In this way, side effects are minimized.
One procedure can be divided into several periods, 2 are allowed:
- The first is up to a year after the procedureconsidered early support. During this time period, a gradual planned decrease in the dose of immunosuppressants occurs.
- The second period is more protracted, carried out one year after the functioning of the transplanted kidney or any other organ continues. And the moment when immunosuppression becomes more stable and enough intermediate supplement, the risks of complications cease.
Selection of drugs
According to all modern protocols that are associated with suppressive therapy, mycophenolate is also used for a positive result. Compared to other applicable azathioprines, there is no manifestation of acute rejection, they are an order of magnitude smaller. Based on these observations, it becomes clear that the survival rate after transplantation is increasing.
Depending on the patient and their specific risks, individual immunosuppressive drugs are identified. This type of selection is considered mandatory, which in no case can be ignored. Replacements are prescribed for standard drugs, and this is the best solution in cases of ineffective action of one or another selection of drugs.
It is not uncommon for diabetes to occur after an organ transplant. This can be caused by steroids in those patients who develop impaired glucose processing, develop post-traumatic diabetes, as a result of which it is advisable to reduce the dose or even stop taking any steroids altogether. Butsometimes there are situations that this measure does not help, so other treatment options will need to be looked at.
Acute transplant rejection
Acute reflection is a sign that the immune system has given its recurrent response, which is intended for the donor's antigens. If such a condition appears, then this indicates that there is a high risk of an increase in creatinine. And, consequently, urination becomes an order of magnitude lower and pain and induration appear in the transport area.
The technical symptoms that are presented are highly sensitive, have their own specific indicators and characteristics, which affect immunosuppressive therapy. That is why at the first stage of treatment it is necessary to exclude any secondary causes of dysfunction. And in order to accurately verify the acute rejection of the transplant, it is necessary to perform a biopsy of the transplanted organ. It should be noted that, in general, a biopsy is an ideal examination after such an unusual treatment. This is to prevent overdiagnosis of acute rejection after a short time has elapsed after transplantation.
What to do after the first episode of defeat?
At the moment when the first exacerbation occurred, which, in turn, carries the characteristics of cellular rejection and increases sensitivity, doctors recommenduse pulse therapy as a treatment. It allows, basically, to prevent rejection. In order to perform this event, "Methylprednisolone" is used. The effectiveness of this procedure is evaluated 48 or 72 hours after treatment. And the dynamics of the level of creatinine is taken into account. Experts note the facts that already on the 5th day after treatment begins, creatinine levels return to their original position.
There are cases where they remain for the entire period of acute rejection. But at the same time as the therapy will be carried out, it is necessary to make sure that the concentration is in the acceptable range. With regards to the dose of "Mycophenolates", in no case should it be lower than the recommended rate. If rootless acute rejection develops, whether adequately maintained or not, a conversion to tacrolimus should be made.
As for repeated pulse therapy, it only works in the case of acute rejection, but it should be taken into account that this method is used no more than twice. Unfortunately, the second period of rejection requires heavy steroid exposure. It is necessary to prescribe a drug that will fight antibodies.
Scientists who are investigating this issue recommend starting antibody treatment immediately after pulse therapy has been started. But there are other supporters of this theory, they suggest that it is necessary to wait a few days after the course of therapy and only then use steroids. Butif the organ that was installed in the body begins to deteriorate its work, this indicates that it is necessary to change the course of treatment.
Proper treatment during chronic graft injury
If the transplant gradually begins to fail to perform its functions, then this indicates that deviations from the norm have occurred or fibrosis has occurred, chronic rejection makes itself felt.
In order to get a good result after transplantation, it is necessary to rationally use all modern possibilities, apply immunosuppressive therapy, and use a complex medical technique. Conduct timely diagnosis, monitor, and perform preventive treatment. For some types of procedures, it is recommended to use sunscreen. And immunosuppressive therapy in this case will be much more effective.
As with anything else, immunosuppressive drugs have side effects. Everyone is well aware that taking absolutely any drug can cause unpleasant manifestations in the body, which you must first learn about and be ready to fight.
During the use of drugs intended for treatment, special attention is paid to arterial hypertension. I would like to note the fact that in the case of long-term treatment, blood pressure rises much more often, this occurs in almost 50% of patients.
Newly developed immunosuppressive drugs have lessnumber of side effects, but, unfortunately, sometimes their effect on the body leads to the fact that the patient has a mental disorder.
Azathioprine
In immunosuppressive therapy for glomerulonephritis, this drug has been used for 20 years, which should be taken into account. It inhibits the synthesis of DNA and RNA. As a result of the work done, there is a violation during the division of mature lymphocytes.
Cyclosporine
This medicinal product is a peptide of plant origin. It is obtained from fungi. This drug is engaged in the fact that it disrupts the synthesis and blocks the destruction of lymphocytes and their distribution in the body.
Tacrolimus
Drug of fungal origin. In fact, it performs the same mechanism of action as the previous remedies, but, unfortunately, as a result of the use of this drug, the risk of diabetes mellitus increases. Unfortunately, this drug is less effective during the recovery period after a liver transplant. But at the same time, this drug is prescribed when a kidney transplant occurs and it is at the stage of rejection.
Sirolimus
This drug, like the previous two, is of fungal origin, but it has a different mechanism of action on the human body. What he does is destroy proliferation.
Judging by the reviews likeboth patients and doctors, it becomes known that the timely use of drugs during transplantation is a guarantee that the chance of survival of the transplanted organ is increased and possible causes of its rejection are prevented.
For the first period of time, the patient is under the close supervision of specialists, they constantly monitor the patient’s state of he alth, record various reactions to certain stimuli, everything is necessary so that in the event of the first signs of rejection of the transplanted organ, attempts should be made prevent it.
