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Immunosuppression in Solid-Organ Transplantation: Essentials and Practical Tips

Jasiak, Natalia M. PharmD; Park, Jeong M. PharmD

doi: 10.1097/CNQ.0000000000000117
Original Articles
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A multidisciplinary team approach is essential for successful management of patients with solid-organ transplant. Transplant nursing encompasses care and support of transplant recipients as well as caregivers and organ donors through all phases of transplantation, from pretransplant evaluation to posttransplant recovery and maintenance. The field of solid-organ transplantation has advanced rapidly, and new treatments continue to emerge. Nurses who are responsible for the care of transplant recipients should have a knowledge base in transplant immunology and pharmacology. This review discusses mechanism of action, indication, side effects, and drug interactions of commonly used immunosuppressive medications in solid-organ transplantation. Nonoral routes of drug administration, therapeutic drug monitoring, and patient monitoring strategies are also included as practical tips for bedside nurses who are responsible for delivery of direct patient care and education of patients and their caregivers. This review focuses on the following medications: antithymocyte globulins, basiliximab, alemtuzumab, corticosteroids, tacrolimus, cyclosporine, azathioprine, mycophenolate mofetil/mycophenolate sodium, sirolimus, everolimus, belatacept, intravenous immunoglobulin, and rituximab.

College of Pharmacy, University of Illinois at Chicago (Dr Jasiak); and Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor (Dr Park).

Correspondence: Jeong M. Park, PharmD, Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Victor Vaughan Bldg, Room 302, 1111 Catherine St, Ann Arbor, MI 48109 (jeongp@med.umich.edu).

The authors have no conflicts of interest related to this work to acknowledge.

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