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Management

Authoring team

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.

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