Complications Associated with Immunosuppression


In order for the renal transplant to function and not be rejected by our body for the work of the immune system, we need to reduce or block the action of certain components of the immune response.

We do this by administering drugs aimed at certain metabolic pathways as specific as possible that allow us to reduce the adaptive immune response without affecting the innate measure to a greater extent, but they entail another series of factors, entities or risks that we will detail in this post.

The risk of infections

Infections are the first cause of death after a kidney transplant in Delhi. Logically, by decreasing the body’s defenses the main risk is represented by infections. Both the usual and those called generated by the so-called opportunistic pathogens (those microorganisms that usually would not cause infection in a healthy patient, are able to infect and make an immunosuppressed patient sick). The greatest risk of infection occurs in the first 3 months after transplantation, since at the beginning higher doses of immunosuppressants are administered to avoid acute graft rejection, says nephrologist in Delhi.

The most common infections are respiratory infections and urinary infections, secondly gastrointestinal infections; There is usually a history of an infected relative who may have been the cause of the infection, explains nephrologist in Noida.

With respect to opportunistic pathogens, the most frequent are viruses starting with cytomegalovirus (CMV) and polyomaviruses (BK and JC viruses), hepatitis viruses, herpes, chickenpox, to name a few. Then we find bacteria such as Nocardia, listeria, pneumocystis, among others.

In some cases, we can reduce the risk of infection by getting vaccinated. All transplanted patients should receive a series of vaccines to reduce the risk of infection by these microorganisms; however, it should be noted that vaccines with live or live-attenuated microorganisms should NOT be administered, only those with inactivated, dead microorganisms or bacterial/viral proteins should be administered, says doctor for kidney transplant in Delhi.

Vaccination and prophylaxis

Another way to reduce the risk of infection is through prophylaxis (that is, preventive treatment). Depending on the epidemiological environment of the center where the transplants are performed, more or less prophylactic medications are administered and usually maintained only during the first 3 to 6 months.

However, if in spite of all this, a transplanted patient contracts an infectious disease, it is important that he notify his nearest health professional, and in the case of fever, go to the hospital emergency department as soon as possible, suggests kidney Specialist in Noida.

Immunosuppressive toxicity

Immunosuppressive medications can generate negative effects not only by their direct action, but also by indirect actions or adverse reactions of each family of medications.

On the one hand, we have the anticalcineurinics (cyclosporine and tacrolimus) almost indispensable in most immunosuppression regimens in some patients can general gum growth, hair loss, neurological disorders, insomnia and even direct kidney damage (in very high concentrations).

On the other, mycophenolate (purine nucleotide synthesis blocker) is characterized by generating gastrointestinal disturbances, commonly diarrhea. Another similar medication, azathioprine can cause anemia or leukopenia (decrease in white blood cells below adequate values).

Finally, another group of medications known as mTOR inhibitors, sirolimus and everolimus can cause anemia, hypertension, slow healing or generate joint pain.

As we can see, the effects that these drugs can generate are varied, but their usefulness and benefit outweigh these risks, so it is important that if you notice any alteration or change in normality related to the effects mentioned above, contact your kidney transplant doctor in Delhi.