The therapy itself is intended to suppress unwanted immune responses to stimuli.
Often this technology is used to get rid of autoimmune diseases - these are pathologies during which the immune system suffers very much, attacks are carried out on the body and its own organs are destroyed. In more detail about the definition of anti-inflammatory and immunosuppressive therapy for rheumatological diseases and kidney diseases - more.
What it is?
One can often hear that immunosuppressive therapy is used during transplantation, it is necessary in order to prevent possible attacks of rejection of an organ that has been transplanted from another organism. It is also widely used after bone marrow transplantation. Such treatment is extremely important in order to carry out the prevention of the disease, as well as during the acute phase.
Complications
There are also chronic reactions of the transplant to a new host; complications of immunosuppressive therapy for glomerulonephritis are called differently. This is due to the fact that it is the donor system that begins to negatively affect the patient's body. Unfortunately, immunosuppressive therapy entails negative consequences, the risk of an infectious disease increases, which is why this technique should be combined with other measures that are designed to reduce the risk of infection.
Treatment
Specific immunosuppressive therapy has cytostatics, glucocorticoids at its disposal. These drugs are secondary, as are Sirolimus, Tacrolimus and others. In parallel, other agents are used, such as monoclonal antibodies. They are designed to get rid of the negative effects at a certain cellular level in the immune system.
Supportive Immunosuppression
There are a lot of indications of immunosuppressive therapy for glomerulonephritis. But the main thing is the following: this procedure should provide the greatest possible life expectancy with the graft that was placed in the human body. And this, in turn, is a determining and, at the same time, adequate suppression of immunity at the time of risk. Thus, side effects are minimized.
One procedure can be divided into several periods, 2 is allowed:
- The first is that up to a year after the procedure, it is considered early support. During this time period, a gradual planned reduction in the dose of immunosuppressants occurs.
- The second period is longer, carried out one year after the functioning of the transplanted kidney or any other organ continues. And the moment when immunosuppression acquires a more stable level and enough intermediate supplementation, the risks of complications cease.
Drug selection
According to all modern protocols that are associated with suppressive therapy, mycophenolate is also used for a positive result. Compared with other applicable azathioprine, there is no manifestation of acute rejection, they are an order of magnitude smaller. Based on these observations, it becomes clear that the survival rate after transplantation is increasing.
Depending on the patient and his specific risks, individual immunosuppressive drugs are detected. This type of selection is considered mandatory, which in no case can not be ignored. Replacement is prescribed for standard drugs, and this is the best solution in cases of ineffective action of one or another selection of medicines.
There are frequent cases of diabetes after an organ transplant. This can be caused by steroids in those patients who have impaired glucose processing, post-traumatic diabetes appears, as a result, it is advisable to reduce the dose or even stop taking any steroids. But sometimes there are such situations that this event does not help, so it will be necessary to look for other treatment options.
Acute graft rejection
Acute reflection is a sign that the immune system has given its recurrent response, which is intended for donor antigens. If such a condition appears, then this indicates that there is a high risk of an increase in creatinine. And, therefore, urination becomes an order of magnitude lower and pain and hardening appear in the transport area.
The technical symptoms that are presented are highly sensitive, have their own specific indicators and characteristics, which affects immunosuppressive therapy. That is why at the first stage of treatment it is necessary to exclude any secondary causes of dysfunction. And in order to accurately verify the acute rejection of the transplant, it is necessary to perform a biopsy of the organ that was transplanted. It should be noted that in general a biopsy is an ideal examination after such an unusual treatment. This is necessary in order to prevent overdiagnosis of acute rejection after a short time has passed after transplantation.
What to do after the first episode of defeat?
At the moment when the first exacerbation occurred, which, in turn, carries cellular rejection and increases sensitivity, doctors recommend using pulse therapy as a treatment. It allows you to mainly prevent rejection. In order to carry out this activity, "Methylprednisolone" is used. The effectiveness of this procedure is assessed 48 or 72 hours after treatment. And the dynamics of creatinine level is taken into account. Experts note the facts that already on the 5th day after the treatment begins, creatinine values return to their original position.
There are such cases that they remain for the entire period of acute rejection. But at the same time as the therapy will be carried out, you need to make sure that the concentration is in the acceptable range. As for the dose of "Mycophenolates", then in no case should it be lower than the recommended norm. In the case of the development of rootless acute rejection, regardless of whether the maintenance is adequate or not, it is necessary to convert to tacrolimus.
With regard to repeated pulse therapy, it brings effect only in the case of acute rejection treatment, but it is worth considering the fact that this method is used no more than two times. Unfortunately, the second period of rejection requires severe steroid exposure. It is necessary to prescribe a drug that will fight the antibodies.
Scientists who deal with this issue recommend starting treatment with antibodies immediately after pulse therapy has been started. But there are other supporters of this theory, they suggest that after a course of therapy it is necessary to wait a few days and only then use steroids. But if the organ that was installed in the body begins to worsen its work, this suggests that it is necessary to change the course of treatment.
Proper treatment during chronic graft damage
If the transplant gradually begins to fail to perform its functions, then this indicates that a deviation from the norm has occurred or fibrosis has occurred, and chronic rejection is evident.
In order to get a good result after transplantation, it is necessary to rationally use all the modern possibilities, apply immunosuppressive therapy, use a comprehensive medication technique. Conduct timely diagnosis, monitor, perform preventive treatment. For some types of procedures, it is recommended to use sunscreen. And immunosuppressive therapy in this case will be much more effective.
As in any other direction, immunosuppressive drugs have side effects. Everyone knows that taking absolutely any drug can cause unpleasant manifestations in the body, which you must first learn about and be prepared to fight.
During the use of drugs intended for treatment, special attention is paid to arterial hypertension. I want to note the fact that in the case of prolonged treatment, blood pressure rises much more often, this occurs in almost 50% of patients.
Newly developed immunosuppressive drugs have fewer side effects, but, unfortunately, sometimes their effect on the body leads to the fact that the patient develops a mental disorder.
"Azathioprine"
In immunosuppressive therapy for glomerulonephritis, this drug has been used for 20 years, which should be taken into account. It suppresses the synthesis of DNA and RNA. As a result of the work done, a violation occurs during the division of mature lymphocytes.
"Cyclosporin"
This drug is a peptide of plant origin. It is extracted from fungi. This drug is designed to disrupt the synthesis and block the destruction of lymphocytes and their distribution in the body.
Tacrolimus
The drug is of fungal origin. In fact, it performs the same mechanism of action as the previous means, but, unfortunately, the use of this medicine increases the risk of diabetes. Unfortunately, this drug is less effective in the recovery period after liver transplantation. But at the same time, this drug is prescribed in the case when a kidney transplant occurs, and it is at the stage of rejection.
"Sirolimus"
This medicine, as well as the previous two, is of fungal origin, but it has a different mechanism of action on the human body. He is committed to destroying proliferation.
Judging by the reviews of both patients and doctors, it becomes known that the timely use of drugs during transplantation is a guarantee that the chance of survival of the transplanted organ increases and the possible causes of its rejection are prevented.
The first period of time, the patient is closely monitored by specialists, they constantly monitor the patient’s health status, record various reactions to various stimuli, everything is necessary in order to try to prevent this in case of the first signs of rejection of the transplanted organ.