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Post Transplant Immune Suppression

Post Transplant Immune Suppression. Lung Transplant Education Series Valerie Durney, NP, CCTC. OVERVIEW. Why do I need these medications? Which of my medications suppress my immune system? What are common side effects of these medications? What symptoms should I be aware of?

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Post Transplant Immune Suppression

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  1. Post Transplant Immune Suppression Lung Transplant Education Series Valerie Durney, NP, CCTC

  2. OVERVIEW • Why do I need these medications? • Which of my medications suppress my immune system? • What are common side effects of these medications? • What symptoms should I be aware of? • What are important things to know about these pills? Post Transplant Immune Suppression

  3. After lung transplant your immune system needs to be altered to prevent rejection or your own body trying to fight the new lung(s) • Ideally, your body will become tolerant to the new lung Post Transplant Immune Suppression

  4. We achieve this goal with the medications you are prescribed, they work in combination to suppress your immune system • It is extremely important to take your medications as directed • Once you are home develop a system to ensure you take your medications on time Post Transplant Immune Suppression

  5. The transplant team will monitor your blood levels to achieve the most appropriate level of immune suppression for you • This may place you at risk for catching illnesses from others Post Transplant Immune Suppression

  6. PRECAUTIONS • Precautions need to be instituted at home to help prevent the spread of infection Good hand-washing is the #1 precaution in stopping the spread of infection Post Transplant Immune Suppression

  7. WHICH OF MY MEDICATIONS SUPPRESS MY IMMUNE SYSTEM • Prograf • CellCept • Prednisone Post Transplant Immune Suppression

  8. PROGRAF • Most important medication! • Needs to be taken every 12 hours • Interacts with many medications Post Transplant Immune Suppression

  9. PROGRAF: COMMON SIDE EFFECTS • Tremors • Headache • GI: Nausea/diarrhea • Kidney problems • Low magnesium • Elevated blood sugars Post Transplant Immune Suppression

  10. PROGRAF Formulations: 0.5mg, 1mg & 5mg capsules • BRAND NAME NECESSARY • Acceptable alternative to Prograf is: Hecoria (this a newer brand name medication) Post Transplant Immune Suppression

  11. PROGRAF • We will check blood levels of Prograf to ensure your level is within a target range • Blood levels need to be a 12 hour trough-this means your blood is drawn 12 hours after your last dose • Please eat/drink as usual prior to your clinic labs as you do NOT have to be fasting Post Transplant Immune Suppression

  12. PROGRAF • You can take your AM Prograf dose after your blood is drawn Please avoid grapefruit juice, as this can elevate your blood level of Prograf Post Transplant Immune Suppression

  13. CELLCEPT • Formulations: 250 & 500mg capsules • Taken every 12 hours • Important to take with food • Should be separated from antacids • Generic Ok Alternative to CellCept is Myfortic. This is enteric coated CellCept Post Transplant Immune Suppression

  14. CELLCEPT: COMMON SIDE EFFECTS • Nausea/vomiting • Diarrhea • Low blood counts • *Pregnancy concerns* Post Transplant Immune Suppression

  15. PREDNISONE • Tapered dosing over the first 4 months after transplant • Goal dose = 5mg • Taken every morning • Generic Ok Post Transplant Immune Suppression

  16. Elevated blood sugars Elevated blood pressure Weight gain Puffy face Insomnia Irritability/moodiness Bone weakness/osteoporosis PREDNISONE: COMMON SIDE EFFECTS Post Transplant Immune Suppression

  17. GENERAL TIPS • Keep out of reach of children • Check with transplant team before starting a new medication prescribed from another provider • Always swallow capsules whole and never chew/crush or open capsules Post Transplant Immune Suppression

  18. GENERAL TIPS • Purchase a pill box to keep organized • Consider setting an alarm to avoid forgetting doses • Discuss with transplant team any concerns about side effects to medications • Avoid herbal supplements Post Transplant Immune Suppression

  19. GENERAL TIPS • Always keep an up to date medication list with you at all times • Plan ahead for refills! • Please purchase a medical alert bracelet in case of emergencies that states you are a transplant patient and keep a list of your medications in your wallet Post Transplant Immune Suppression

  20. Post Transplant Immune Suppression Always contact your transplant coordinator for with any questions or concerns! Linda: 617-732-7299(last names starting with A-K) Betsy: 617-732-5971(last names starting with L-Z) or via Patient Gateway

  21. REFERENCES • Transplantation Drug Manual, 5th Edition • J. Pirsch, H. Sollinger, X. Liang • Landes Bioscience • Austin, TX USA • Transplantliving.org • BWH: A Guide To The Care of Lung Transplant Recipients At BWH

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