Allogenic transplantation requires some quantity of immunosuppression when the transplant is to live. However the immunosuppressive drugs act against all antigens that place the recipient at huge risk of infection. Patients on long term immunosuppressive therapy are at raised risk of cancer, hypertension and many other diseases.
Azathioprine is specified just before and after transplantation. It inhibits mitosis. Both B and T cell proliferation is reduced in the existence of Azathioprine. Corticosteroids like prednisone act as an anti-inflammatory agent. Cyclosporin A and Rapamycin are fungal metabolites with immunosuppressive properties. Lymphocytes are tremendously sensitive to the X-rays; therefore X-ray irradiation can be employed to remove them in the transplant recipient just before grafting.
The most generally transplanted organ is the kidney. Many general diseases like diabetes and various kinds of nephritis outcome in kidney failure, as an outcome transplantation is needed.
Graft versus–host disease:
In leukemia, the patients are treated with cyclophosphamide (i.e., immunosuppressive drug) and the body is irradiated to kill every cancerous cells. Now this patient is immunosuppressed and will not refuse any graft.
To have ordinary immune function (i.e., to fight infections and so on) bone marrow cells that contain immunocompetent cells are transplanted from ordinary donors. In this situation the bone marrow cells are not discarded by the recipient, however rather the immunocompetent cells exists in the bone marrow, identify the recipient tissues as foreign and decline the host.
This occurs after activation, proliferation and generation of cytokines leading to inflammatory reactions. This is termed as graft versus host (i.e., GVH) reaction. The reactions take place in the skin, gastrointestinal tract and liver. In rigorous GVH reaction liver failure takes place.
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