Chapter 16. Some Clinical Problems of Immunosuppression

  1. Ruth Porter and
  2. Julie Knight
  1. D. B. Evans

Published Online: 30 MAY 2008

DOI: 10.1002/9780470719985.ch16

Ciba Foundation Symposium 15 - Corneal Graft Failure

Ciba Foundation Symposium 15 - Corneal Graft Failure

How to Cite

Evans, D. B. (1973) Some Clinical Problems of Immunosuppression, in Ciba Foundation Symposium 15 - Corneal Graft Failure (eds R. Porter and J. Knight), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470719985.ch16

Author Information

  1. Renal Unit, Addenbrooke's Hospital, Cambridge

Publication History

  1. Published Online: 30 MAY 2008
  2. Published Print: 1 JAN 1973

ISBN Information

Print ISBN: 9789021940168

Online ISBN: 9780470719985

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Keywords:

  • corticosteroids;
  • azathioprine;
  • immunosuppression;
  • cyclophosphamide;
  • antilymphocyte

Summary

Immunosuppressive treatment used in the prevention of immune rejection of allografts, and in autoimmune and other diseases, can be associated with unpleasant clinical complications. The present mainstays of treatment include corticosteroids, azathioprine, cyclophosphamide and antilymphocyte globulin, used in various doses and combinations. All these agents, however, are cell poisons and although the primary attack is directed at cells of the lymphoid series, other cellular structures may be injured. Careful control of immunosuppressive dose regimes minimizes side-effects but because of interference with antibody synthesis, infections of all types often occur. Early complications are related to relatively high doses of immunosuppressive agents and include bone marrow depression, gastrointestinal bleeding, diabetes mellitus and infections. Long-term follow-up reveals complications of a different nature—cardiovascular, musculoskeletal, neoplastic and ophthalmic—which are probably more related to the chronicity of the treatment regime. It is unfortunate that many recipients of successful long-term allografts are afflicted by such crippling iatrogenic complications.