Post Transplant

Posted By  CCF Cardio MD-SGM on December 30, 1997 at 08:55:17:

In Reply to: Post Transplant posted by Traci on December 29, 1997 at 16:01:33:

: Two months following a heart transplant, being on Neoral, Prednisone and Imuran
  for the immunosuppresants.  Is it normal or "OK" to be taken completely off of I
  Imuran for a period of 3 weeks without replacing it with something else?  
  This means that for 3 weeks the only immunosuppressants administered were Neoral and
  Prednisone?  Would this cause any side affects or is this acceptable?

[CCF Cardio MD-SGM]

Dear Traci,
The management of immunosuppressive medications following organ transplant could be described as a delicate balancing act.  Numerous factors are considered in an equation that seeks to subdue the immune system while minimizing unacceptable side effects including low white blood cell count, kidney dysfunction, electrolyte abnormalities, and many other possible toxicities of these medications.  Imuran, or azathioprine, is sometimes referred to as a "steroid-sparing" drug.  Using this medication facilitates the use of lower prednisone doses, which is desirable due to the many side-effects of prednisone.  
Imuran is not typically deemed to be essential in the immunosuppressive regimen, and withdrawing it for a period of time, especially if the white blood cell count is appreciably low, is quite reasonable.  It