Patient after cardiac transplant

1. The major focus of medical and nursing care after transplantation is to prevent early identification of rejection so that appropriate interventions can be initiated. The major reason for transplant failure is rejection. Rejection may be hyper-acute, acute or chronic. 
2. Hyper-acute rejection occurs at the time of transplant or within 48 hours after transplant. 
3. Acute rejection occurs usually occurs within one week to up to three months after transplant. 
4. Chronic rejection occurs form three months to longer after transplant. 
5. Immunosuppressive agents are administered to transplant patients to prevent rejection. The commonly used drugs are Azathioprine, coricosteriods cyclosporine, lymphocytic immune globulin and OKT3. The last two are used to treat acute rejection episodes. The first two are used lifelong in all patients with transplant. 

Azathioprine inhibits RNA and DNA syntheses and decrease proliferation of immune cells.

Route: IV, oral. 1-3mg/kg body weight or as prescribed. Oral dose is metabolized in liver.