Copyright ©The Author(s) 2021.
World J Transplant. Dec 18, 2021; 11(12): 503-511
Published online Dec 18, 2021. doi: 10.5500/wjt.v11.i12.503
Table 1 Therapeutic agents used during solid organ transplantation period and their side effects
Side effects
IVIGReduces HLA sensitivity. The goal of the IVIG therapy is to lower the level of HLA antibodies and limit their ability to attack a transplanted organHeadache, fever, urticaria, eczema, hypotension, anaphylactic shock, TRALI, immune thrombocytopenic purpura. Delayed side effects: Renal impairment, transfusion related infection
GlucocorticosteroidsMimic the effects of cortisol side effects block T-cell derived and antigen presenting cell derived cytokine expressionHypertension, hirsutism, susceptibility to infection, osteoporosis, necrosis, insulin resistance, growth retardation
Calcineurin inhibitors (cyclosporine, tacrolimus)Inhibition the key signaling phosphatase calcineurin, which is an enzyme that activates T-cells of the immune systemNephrotoxicity, promoting of the de novo cancers, metabolic disorders such as diabetes, dyslipidemia, gingival hyperplasia, hirsutism, hypertension, susceptibility to infection
Antiproliferative agents (Mycophenolic acid, azathioprine)Inhibiting purine base synthesis and arresting T- and B-cell proliferationNausea, sleep disturbance, headache, constipation, diarrhea, weakness, fever, hematuria
mTOR inhibitors (sirolimus, everolimus)Alternative for calcineurin inhibitors and antiproliferatives. T-cell proliferation inhibition. Binds to the specific cytosolic protein FKBP-12Hypertension, hyperlipidemia, anemia or thrombocytopenia, headache, proteinuria, interstitial lung disease, mouth ulcers
AzathioprineDecrease DNA and RNA synthesis reduce the production of lymphocytesNausea, hepatotoxicity, leukopenia, thrombocytopenia, malignancies