Immunosuppression

	Methyl Prednisolone 500 mg IV just prior to releasing clamps and again at 24 hours.
	Standard immunosuppression will be Tacrolimus (FK506) led triple therapy. Tacrolimus 0.1 mg/kg/day given as two doses at 1000 and 2200 Prednisolone 20 mg once daily at 0800 Azathioprine 1-2 mg/kg (usually 75-100 mg) once daily at 0800
	Patients who have an increased risk of rejection will receive Tacrolimus led triple therapy, but with MMF substituted for Azathioprine. Tacrolimus as per standard regime Prednisolone as per standard regime Mycophenolate Mofetil 2 grams/day given as two doses at 0800 and 2000 (note: not at the same time as Tacrolimus)

High risk Patients Include:

• Previously sensitised patients - those with panel reactive antibody titres of > 50%.
• FACS +ve crossmatch
• B cell +ve crossmatch
• More than one transplant in the past
• Past episodes of graft loss due to acute rejection
• HLA mismatch - non favourable

Basiliximab

May also be given to patients with expected delayed graft function to allow reduced Tacrolimus dose (0.05mg/kg/day given as two doses), and sometimes to patients believed to be at increased risk of rejection.

Links

Treatment of acute rejection

 

 

Transplant protocols developed on the Edinburgh Transplant Unit. This page first published March 2002 by Amit Adlakha, updated November 2006 and last modified Tuesday, August 11, 2009.

NOTE that the accuracy of any statements in this information CANNOT be guaranteed. It is published in the belief that it is correct, and we endeavour to keep it so - but we do make mistakes. Furthermore, over some subjects there are differing opinions, or differing degrees of certainty. We have usually not attempted to discuss these here because the aim has been to provide an immediate and brief guide. In all areas, prior medical knowledge is assumed. The EdRenHANDBOOK is not suitable for use by those without such a background. Contact us by email or at the address given at the foot of the contents page with any comments or corrections.