Non-Infectious Complications of Immunosuppressant Medications in Renal Transplant Patients

Prasad      Bichu; Kunal      Chaudhary

doi:10.2174/157488412803305777

Abstract

Over the years Renal Transplant has become increasingly successful and fairly routine in terms of availability to prospective patients. More effective and better tolerated medications have led to decreased adverse immunologic events after transplant leading to improved graft survival. Moreover, since the last few years renal transplant is being offered to a wider range of patients with variety of comorbidities, thus making the surveillance of long term complications of immunosuppression (IS) medications critical for both graft and patient survival.

As the use of newer and more potent medications becomes more wide spread, their adverse effects, interactions amongst themselves as well as with other medications, are necessary to recognize and follow closely specially in patients with other comorbidities. Although infections resulting from IS are common; other noninfectious complications cause significant problems in a transplant patient. Post-transplant, several preexisting risk factors like hypertension (HTN), dyslipidemia and hyperglycemia usually get exacerbated resulting in accelerated atherosclerosis causing cardiovascular disease which is the most common cause of death in transplant patients. Some IS medications have been implicated as a cause for certain malignancies and their close surveillance and timely intervention is an important aspect of care for these patients. Therefore an understanding of these medications and their adverse effects is of paramount importance for the successful medical management of these patients. In this manuscript we review the transplant IS and systematically outline their various noninfectious adverse effects.

Keywords: Complications, Immunosuppression, Renal Transplant, development, hypertension, Cardiovascular Disease, Coronary Heart Disease, Cardiomyopathy, Metabolic Syndrome, Post-Transplant Malignancy, Polyclonal Antibodies, Sirolimus, Mycophenolate mofetil.