management

Last reviewed 01/2018

Immunosuppressive therapy should be commenced promptly after transplantation. The most popular regime is to prescribe cyclosporin A alone, or together with prednisolone and/or azathioprine i.e. mono, double or triple therapy.

Graft rejection should be monitored by:

• serum creatinine - a rise in levels during the first days or weeks after transplantation may be due to rejection or to other causes, for example, cyclosporin toxicity
• renal biopsy

Treatment of acute rejection consists of:

• high-dose intravenous steroids
• anti-thymocyte immunoglobulin

Mycophenolate mefetil may have a role in maintenance immunosuppression and in the treatment of acute rejection.