What is Anti-Rejection (Immunosuppressant) Medicine?
Anti-rejection medications are essential for having and maintaining a successful hand/arm transplant. Anti-rejection medicine works by preventing the body’s immune system from viewing the new organ as a foreign object and attacking it (e.g., rejecting the hand/arm transplant).¹
Transplant recipients are usually prescribed a combination of anti-rejection medications in the form of pills or tablets that must be taken on a strict schedule.²
If a recipient experiences acute hand/arm transplant rejection, they may be prescribed skin cream that is an immunosuppressant medication.²
Hand/arm transplant recipients need to take anti-rejection medicines for the rest of their lives (while they have the transplant).¹
While anti-rejection medicine is necessary for hand/arm transplant recipients to protect their transplants, there are some risks and side effects to consider.
What Are the Risks and Side Effects of Taking Anti-Rejection Medicine (Immunosuppressants)?
Transplant recipients are more likely to get infections or become sick because anti-rejection medicine suppresses the body’s natural immune response, which is necessary to prevent the body from rejecting the hand/arm transplant.³
Anti-rejection medications are given in small doses so the body can stop extensive infection without rejecting the transplanted hand or arm.¹
In addition to making hand/arm transplant recipients more vulnerable to sickness from infections such as the common cold or the flu, anti-rejection medicines have many side effects.
Some of the common side effects are listed below:
Acne
Constipation
Decreased bone density
Diarrhea
Dizziness
Excessive hair growth
Headache
Heartburn
Loss of appetite
Muscle or joint pain
Nausea
Skin Rash
Stomach pain
Trouble sleeping
Vomiting
Weakness
Weight gain
Additionally, taking anti-rejection medicine for an extended period puts hand/arm transplant recipients at risk for adverse health effects including:
Bone fractures
Cardiovascular disease
Diabetes
End-stage organ damage
Kidney disease
Osteoporosis
Over-immunosuppression (neoplasia)
Skin cancer and other types of cancer
Serious infection
What Are the Risks of Discontinuing Anti-Rejection Medicines?
If a recipient experiences a rejection episode after stopping their anti-rejection medication, newly acquired function of the hand/arm transplant can be lost.
Depending on whether the recipient does hand therapy after the rejection episode, the loss of function can be temporary or permanent. This means the recipient will need to put in more work to regain the function that they lost from the rejection episode.
What Are Anti-Rejection Medicine Regimens Like?
A medication regimen specifies the number of medications and number of times per day that you need to take each medicine. The anti-rejection medicine regimen usually includes many different medications.
It is important to take medicines at the required times each day to always keep a certain level of medicine in your blood. Too little medicine will not prevent your body from attacking the new hand.
What Are the Limits of Medical Knowledge About Hand/Upper Limb Medicines?
The current anti-rejection treatment used for hand/arm transplants was modeled from the standard treatment for other solid organ transplants, like kidneys, to achieve long-term survival of the hand/arm.
Acute rejection rates are higher for hand/arm transplants than for other solid organ transplants. Further research is needed to determine why there is this difference, and how to improve the anti-rejection treatment for hand/arm transplants.