Prepared by Kirsten Chapman, Pharm.D.

Types of Immunosuppression

Post-transplant immunosuppression is usually comprised of a regimen including a combination of drugs suited to each patient’s individual situation, the organ transplanted and current evidence based medical practice in the field of transplantation. Immunosuppression approaches may include any of the following:

• Induction: Immunosuppressive medications given immediately after transplantation with intensified dosing regimens, administered for the purpose of preventing acute rejection. These drugs may be continued after discharge, usually during the first 30 days after transplant – they are not used for long-term maintenance of immunosuppression. Medications that may be used in induction regimens include Methylprednisolone, Atgam, Thymoblobulin, OKT3, Basiliximab or Daclizumab. Rapamune has also been used in induction regimens.

• Maintenance: Maintenance includes immunosuppressive medications given before, during or after transplant with the intention of long-term use. Maintenance immunosuppression does not include medications used for induction or to treat rejection episodes. Medications used for maintenance immunosuppression include Prednisone, Cyclosporine, Tacrolimus, Mycophenolate Mofetil, Mycophenolate Sodium EC, Azathioprine or Rapamune.

• Anti-Rejection: Immunosuppressive medications given for the purpose of treating an acute rejection episode during the initial post-transplant period or during follow-up of an acute rejection that has occurred after transplant. Medications that may be used to treat acute-rejection include Methylprednisolone, Atgam, OKT3, Thymoglobulin, Basiliximab or Daclizumab.