Tables
- Table 1 General principles in immunosuppression
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With one drug in a moderate dose, or high dose short-term, you are safe
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With two drugs in low–moderate dose you are safe. With one of two in high dose there is risk of over-immunosuppression
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With three drugs there is always risk of over-immunosuppression irrespective of dose
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Usually a certain degree of immunosuppression can be obtained with different combinations of drugs
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Conventional drugs (steroids, antimetabolites and calcineurin inhibitors) have short-term effect (days to weeks)
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Biological drugs (polyclonal and monoclonal antibodies) have long-term effects (months to years)
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- Table 2 Important points to consider in immunosuppressed patients
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Immunosuppression alters the patients response to acute disease, and reactions are blunted
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Patients have a suppressed reaction to infection and do not appear as ill as they are, and the usual clinical signs are not applicable
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Infection with opportunistic organisms such as fungi, pneumocystis and viruses is always a possibility
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- Table 3 Important points in immunosuppression in lung transplantation
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Most patients require three drugs
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One calcineurin inhibitor must always be included in the treatment
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The dose of each drug can be changed so that the overall immunosuppressive effect is the same
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Most patients have poor renal function and do not tolerate dehydration
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