Scene: Bayside High School – health class
“Today, class, we are going to learn about Immunosuppressants – what a fun topic, ‘eh?”
Jessie whispers to Kelly, “I’m so excited, I’m so excited.”
(If you don’t get the reference, just keep reading on…)
This ‘fun-filled-fact’ post came about after some recent blood work showed one of the anti-rejection meds has awakened the *BK virus in my kidney. The doctor has been lowering my dosage as my BK levels have risen, but I’ve stopped taking it for now.
*BK Virus: What Transplant Patients Need to Know:
“BK virus (BKv) is a virus that most people get in childhood. Symptoms can feel like a common cold. Once you get a BK virus infection, the virus stays in your system for good. But it does not cause a problem for most people. This is called latent, or like being ‘asleep’ in your body. Sometimes, when your immune system is not working well, the virus wakes up. Then, it can cause symptoms of infection. BK virus is also called polyomavirus.” ~ Source: kidney.org
Life after a kidney transplant is a balancing act between protecting the new organ and managing the side effects of the medications that make its survival possible. Anti-rejection drugs are essential because the immune system naturally sees a transplanted kidney as foreign and would attack it without a wrestling referee. Prednisone, Myfortic, and Prograf are three common medications prescribed, and while they are powerful allies in preventing kidney rejection, they come with their own set of challenges. Note, kidney transplant recipients must take these medications… for life, which means learning to live with the medications’ benefits and their drawbacks.
Prednisone:
Prednisone is a steroid that has long been a part of transplant care. Its strength is its ability to suppress the immune system and reduce inflammation, making it effective in preventing organ rejection. However, long-term use can lead to weight gain, high blood pressure (already got it), diabetes (already got it), osteoporosis, mood swings, and increased risk of infections (say, “yikes”).
Myfortic:
Myfortic, also known as mycophenolic acid, is another key anti-rejection drug. It works by weakening the immune system’s ability to attack the transplanted kidney. Yet, it can cause gastrointestinal issues like nausea or constipation. Despite these concerns, Myfortic remains a part of therapy because it reduces the risk of rejection when combined with other medications. This is the med that threw cold water on my snoozing snoring BKv.
Prograf/Tacrolimus:
Prograf, or Tacrolimus, is used across different organ transplants. It is effective in preventing rejection by targeting specific immune cells. The downside is that it can cause tremors, headaches, kidney toxicity, and neurological side effects. Patients must also be consistent with how they take it, since food can affect absorption. Even with all these side effects, Prograf is one of the drugs for long-term transplant success.
While these medications protect the kidneys, they also weaken the immune system, which can cause infections like the BK virus. This virus is common and usually dormant in the body, but after a transplant, it can reactivate because of immunosuppression. Since the BK virus can damage the poor new kidney, monitoring for BK virus through regular blood and urine tests is critical, and if it becomes active, doctors often reduce immunosuppression to help the body fight it off. There is no cure, so vigilance and early detection are the best.
The reality for any transplant recipient is that these medications are not temporary. Since they are lifelong companions, they are important in order to preserve the new kidney. The pros are clear: without them, organ rejection would almost certainly occur. The cons are real, with side effects that can affect quality of life and risks like the BK virus that require ongoing monitoring. Yet, for most patients, the trade-off is worth it (especially compared to kidney dialysis).
These anti-rejection medications make it possible to live with a functioning kidney.
(Bell rings) “Class dismissed.”
