A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complication of this drug therapy?
A. Depression
B. Hemorrhage
C. Infection
D. Peptic ulcer disease
Correct Answer: C. Infection
Infection is the major complication to watch for in clients on cyclosporine therapy because it’s an immunosuppressive drug. Urinary tract infections are common within the first 6 months. Opportunistic infections are more likely to occur 1–6 months after transplantation, reflecting the greater impact of immunosuppression during this time. Reactivation of latent pathogens such as polyomavirus BK, hepatitis C virus (HCV), and mycobacterium tuberculosis may also occur.
Option A: Depression may occur posttransplantation but not because of cyclosporine. While kidney transplantation offers several advantages in terms of improved clinical outcomes and quality of life compared to dialysis modalities, depressive symptoms are still present in approximately 25% of patients, rates comparable to that of the hemodialysis population.
Option B: Hemorrhage is a complication associated with anticoagulant therapy. Bleeding is the most important complication of VKAs and a major concern for both physicians and patients. The occurrence of bleeding during treatment is not only important for the treated subjects, but also for correct and complete use of this therapy in all the subjects who have a clear clinical indication for anticoagulation.
Option D: Peptic ulcer disease is a complication of steroid therapy. It is suggested that the mechanisms responsible for peptic ulcer formation induced by corticosteroids include enhanced gastrin and parietal cell hyperplasia with increased acid secretion, diminished gastric mucus synthesis, and suppressed arachidonic acid metabolism and prostaglandin (PG) synthesis.
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