Medications

Understanding transplant medications is an important part of the transplant process. There are several medications needed after a transplant, and some are taken for as long as the islets are functioning. The transplant coordinator works closely with the patient to teach them about the medications and the side effects.

I. Immunosuppressants

After a transplant, medications called “immunosuppressants” are necessary. These medicines “quiet” the immune system and protect the islets from being attacked and destroyed by the patient’s body. The job of the immune system is to fight off substances that are foreign to the body, such as infections, viruses, and cancers. The body would normally recognize cells from another person as foreign and attack (reject) them.

Immunosuppressants work in different ways to prevent rejection. By using a combination of these medications, the chance of rejection of the islets is decreased.

II. Medications to Prevent Infection

Because immunosuppressants suppress the immune system, there is an increased risk of Infection when a patient is taking immunosuppressants. The risk for developing infections is greatest during the first months after the transplant.

The following medications are used to prevent infections.

Bactrim (sulfamethoxazole/trimethoprim)
Bactrim DS
800, 160 mg
Bactrim SS
400, 80 mg

Bactrim is a sulfa antibiotic commonly prescribed to treat various types of infections. It is used to prevent Pneumocystis carinii pneumonia, a type of lung infection.

If the patient is allergic to sulfa drugs, a different antibiotic is used.

Valcyte(valganciclovir) 450mg

Valcyte is an antiviral medication that is used to prevent and to treat cytomegalovirus or CMV.

III. Other Medications

The following is a list of other medications taken after islet transplant.

Lovenox (enoxaparin)

Lovenox is an anticoagulant, or blood thinner. This is taken after each transplant to prevent blood clots.

Aspirin 81mg 325mg

Aspirin is another anticoagulant that helps prevent blood clotting. It is taken after each transplant to prevent blood clots.

Multivitamins

There is some evidence that vitamins may help the islets survive after transplantation. When the islets are transplanted they are injured and produce “free radicals”, substances that are harmful to all cells. Some vitamins help decrease the level of free radicals.

IV. Where to get Medications

All protocol-necessary medications are provided to the patient by Emory for 12 months following the first transplant. During the evaluation process a social worker will discuss issues of insurance coverage and the cost of these medications after 12 months.

The Emory islet transplant team physician may provide the patient with prescriptions for medications to treat conditions that may be related to the transplant. Or, the patient may be asked to visit their own doctor for treatment of unrelated medical conditions.

It is the patient’s responsibility to notify the islet transplant nurse when a refill is needed for a prescription prescribed by the Emory islet transplant physician. The patient should always keep a two-week supply of medications, and a minimum of 24 hours is needed to process refills.

Other facts about taking medications:

• If the patient is sick or nauseated and cannot take the medications, they may need to be admitted to the hospital to receive medications through an IV.
• No new prescription or over-the-counter medications can be taken without checking with the transplant team. Many drugs interfere with the immunosuppressants.
• Medications must be stored in a safe, cool and dry place.

Transplant Center