Thread by @GasBugZa

Next is Dr Bilal Bobat, a hepatologist (also at WDGMC) talking about 'Immunosuppressive Therapy for Transplant'.
@bilalbobat
#CCSSA2022 #FOAMcc #critcare

Azathioprine in the 1950's and 60's and then cyclosporine in the 1980's revolutionised transplant immunosuppression. Most recently, Tacrolimus (especially prolonged release preparations) has become very popular due to great efficacy. #CCSSA2022

5 year survival is best for kidney transplant patients, and worst for lung transplant patients. All survival rates are improving over time however, in no small part due to improved immunosuppression regimens.
#CCSSA2022

Transplant immune suppression is divided into two stages - an induction phase and a maintenance phase. Livers are very immunogenically forgiving, other organs - especially the heart - not so much.
#CCSSA2022

Just a summary of the drugs used (for everyone's benefit):
Calcineurin Inhibitors - Cyclosporine & Tacrolimus
Antimetabolites - Mycophenilate & Azathioprine
Mammalian Target of Rapamycin Inhibitors - Everolimus and Sirolimus
#CCSSA2022

Many of the patients may go onto prophylaxis for a variety of infectious agents, including
- CMV --> Acyclovir
- PJP --> Trimethoprim/Sulfamethoxazole
- Tuberculosis --> Isoniazid
#CCSSA2022