Azathioprine Facts: Why an Immunosuppressive Drug is Needed in Kidney Transplantation

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For a number of reasons, the only real remedy for kidney failure or the permanent loss of kidneys is kidney transplantation. More than what a hemodialysis machine can do, such as cleaning the blood and maintaining the balance of salts and water in body fluids, kidneys also produce a variety of chemicals (including hormones) necessary for normal functioning.

In kidney transplantation, a kidney is taken from a living donor or from a person who has just died. The kidney is placed inside the abdomen of the recipient and is connected to a major artery and vein, as well as to the bladder by means of the ureter in order that urine will flow to the bladder. If everything turns out well in the kidney transplantation, the donated kidney will gradually start functioning.

But in some cases of kidney transplantation, the donated kidney gets “rejected.” When a donated kidney in a kidney transplantation is rejected, it means that the immune system recognized it as a foreign invader and promptly acted to destroy it (much like when it detects the presence of invading bacteria and viruses). To address this problem, doctors involve the use of an immunosuppressive drug, in a kidney transplantation, to weaken the immune system.

An example of immunosuppressive drug is azathioprine, a unique drug used as part of a medical procedure (as kidney transplantation) in which suppression of the body’s normal immune responses is necessary. This exactly is how azathioprine works – it suppresses the immune response mechanism of the body, which normally allows us to respond to infection, allergens, or other foreign objects.

When the immune system is artificially suppressed with azathioprine (examples are the brand names “Azasan” of Salix Pharmaceuticals, Inc. and “Imuran” of Prometheus Laboratories, Inc.), as in the case of kidney transplantation, it allows the transplanted kidney to continue functioning normally in the recipient’s body. Without azathioprine, or any other immunosuppressive drug for that matter, the body of the transplant patient would see the new kidney as an invading foreign object and soon destroy it.

People on whom an immunosuppressive drug has been used become unusually susceptible to infection. Normal responses, like fever, may not be present or may be delayed by this drug. The most often seen and most severe side effects of azathioprine are related to blood components. The side effects may manifest themselves by unusual bleeding, or they may be detected by a weekly blood count.

Other possible adverse effects of using azathioprine include drug fever, sores in the mouth, joint pains, nausea, vomiting, diarrhea, loss of appetite, and loss of hair. Also, if possible, azathioprine should be avoided by pregnant women. If this is not possible, complete weekly blood counts should be done to check for any unusual changes.

Sources:

1. “Immunosuppressive drugs”, on Wrong Diagnosis (online) – http://www.wrongdiagnosis.com/treat/immunosuppressive_drugs.htm

2. “What are Immunosuppressive Drugs?”, on wiseGEEK (online) – http://www.wisegeek.com/what-are-immunosuppressive-drugs.htm

3. Urology – “Kidney Transplantation”, on the University of Virginia Health System (online) – http://www.healthsystem.virginia.edu/uvahealth/adult_urology/trans.cfm

4. “Azathioprine Index”, by Annette O. Gbemudu, PharmD, MBA; edited by Jay W. Marks, MD, on MedicineNet.com – http://www.medicinenet.com/azathioprine/article.htm

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