ALS as an immunosuppressive agent

ALS is used, often in combination with other immunosuppressive agents, to avoid allograft rejection. In a quadruple therapy protocol it is used with azathioprine, steroids and cyclosporine. ALS is used both as a preventive immunosuppressant, for initial treatment of rejections, and to treat steroid-resistant rejection. The mechanism of action is not fully clarified, but depletion of circulating lymphocytes does occur. This may result from either cytotoxic mechanisms or opsonization. The widest experience with ALS is from kidney transplantation, but ALS has also been used in connection with transplantation of small bowel, heart, bone marrow, liver, pancreas (or islet cells), cornea and skin.

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