What Are Immunosuppressant Drugs and Why Are They Important?

An organ transplant surgery is only one small piece of the organ transplant process. Immunosuppressants are medications given to transplant patients during and after transplant surgeries. For transplant patients, they can make the difference between life and death.

Our immune systems are set up to attack invaders like bacteria and viruses. Normally, this is great for warding off diseases and keeping us healthy. However, when it comes to receiving a transplant organ, our immune systems can turn on the new organ and try to attack and destroy it.  If your body sees the new organ as an invader, it will attack, or “reject” it.

Immunosuppressant drugs help to avoid this by suppressing your body’s immune system. This is key to making sure your body accepts the new organ, but suppressing your immune system can have side effects, such as making you more vulnerable to actual infections. Your doctor adjusts the concentration of the drugs you receive to prevent rejection, while minimizing some of these potential side effects.

Different organs, different approaches

According to the United Network for Organ Sharing (UNOS), post-transplant immunosuppression therapy almost always includes a combination of drugs and medical approaches based on a patient’s individual situation, the type of organ transplanted, and current developments in the field.

Depending on the transplant you receive and how your body reacts to it, this might include one of the following strategies:

• Induction immunosuppression
  This approach tries to minimize acute rejection right after the transplant surgery. These drugs are given in intense doses and up to a month after the transplant, but aren’t used long-term for immunosuppressive maintenance, UNOS reports.
  
• Maintenance immunosuppression
  Maintenance immunosuppression medications try to reduce the chance that your body will reject an organ over a long time period. They don’t treat active rejection, but rather prevent it, and can be given before, during, or after transplant surgeries.
• Anti-rejection immunosuppression
  If you do experience an active rejection episode during the initial post-transplant period or during a specific follow-up period, usually up to 30 days after the diagnosis of acute rejection, you might receive active immunosuppressive medications given for the purpose of treating an acute rejection episode.

Never skip a dose

If you are prescribed anti-rejection medications, you should take these drugs every day as directed, according to the National Kidney Foundation (NKF). For most transplant patients, even missing a single dose can increase the chances that you will start to reject the new organ.

There are exceptions: if you receive a new kidney from an identical twin, for example, you may not have to take the same drugs. Still, According to the NKF, the only time a transplant patient should skip a dose is under the specific care instructions of a physician. If you’ve had an organ transplant and you’re not sure about your medication dosages, immediately call your doctor for clarification.

Because of the large number of pills you may need to take each day, forgetting a dose is easy to do. The NKF recommends you do the following to help you remember:

• Know the name of each drug you take and what it does. If you have a good understanding of your drugs, you will be less likely to forget one.
  
• Use a pillbox or similar medication organizer. This allows you to set up an entire week of pills at once. When the week’s pills are organized, you can see at a glance if you’ve taken your dose for the day or not, and all you have to do is take the right pills for each day at the right time.
• Make a point of taking your medicine at the same time each day to set up a habit.

Missed doses of immunosuppressants

If you’ve forgotten to take a dose, as soon as you remember, call your doctor, the NFK urges. If it’s already time for the next dose, do not take a double dose.

Finally, everyone’s immune system reacts differently to a new organ. Even if you take your medicines every day, it’s still possible to reject a transplanted organ.

About six months to a year after a transplant, the immunosuppression may be lowered, with the chance of side effects decreasing, too, reports the NFK. If you still experience side effects, speak to your transplant team to either change the dose or switch to a different medication. Changes to immunosuppressant medicine should only be made after checking with your transplant center.

While most of us have heard stories of people waiting to receive organ donations, the transplant surgery is only one small piece of the complex organ transplant treatment. Immune suppression drugs make a big impact for many organ recipients, increasing the chances that their bodies accept the new organ and they heal from the operation successfully. To learn more about immune suppression drugs and the organ transplantation process, contact your doctor.