A 45-year-old man develops end-stage renal disease due to diabetic nephropathy. He undergoes a renal transplant with a kidney donated from his sister. Which of the following immune suppression therapies are usually used to prevent rejection in renal transplant patients?
splenectomy and irradiation
plasmapheresis and steroids
cyclosporine and steroids
azathioprine and plasmapheresis
Cyclosporine A blocks production of inter-leukin-2 (IL-2) by helper-inducer (CD4+) T cells. It works alone but is more effective in combination with glucocorticoids. The use of cyclosporine has improved 1-year cadaveric survival rates to the 80%-85% range. Side effects include hepatotoxicity, hirsutism, tremor, and gingival hyperplasia, but only the nephrotoxicity presents a serious management problem.
Kidney