Diabetes mellitus - Treatment with immunosuppressive drugs for organ transplantation Factor
Immunosuppressive drugs for organ transplantation
Immunosuppressive drugs are defined by the RMA as meaning "drugs or agents capable of suppressing immune system responses".
- Organ transplantation involves surgical replacement of an organ (eg heart, kidney, liver) with the corresponding organ from another person and requires ongoing immunosuppressive drug therapy to prevent rejection of the 'foreign' organ.
- Corneal transplants or grafts do not come within this definition of organ transplantation because the cornea does not have a blood supply.
- Immunosuppressive drugs are also used as treatment for autoimmune conditions such as SLE (systemic lupus erythematosus) and severe rheumatoid arthritis.
- Immunosuppressive agents include azathioprine, methotrexate, cyclosporine, prednisone (orally) or methylprednisolone (intravenously) and cyclophosphamide.
- Except with transplants between identical twins (known as isografts or syngrafts), immunosuppressive therapy can rarely be stopped completely after a transplant. However, intensive immunosuppression is usually required only during the first few weeks after a transplant (starting at the time of the transplant) or during a rejection crisis. Subsequently the transplant often seems to become accommodated and can be maintained with relatively small doses of immunosuppressive drugs.
Establishing onset
If a veteran or member had undergone organ transplantation, he or she must have been treated with immunosuppressive drugs (and, at least initially, this would have been at least on a daily basis). However, the converse is not necessarily true ie treatment with immunosuppressive drugs does not necessarily mean that the person has undergone organ transplantation. If a person had undergone organ transplantation, this would be recorded in doctors' notes and/or hospital records. However, these records may have been destroyed or can no longer be obtained. Therefore, if there is a reliable history of organ transplantation at a particular time, this generally will be accepted, unless there is contradictory evidence.
Last reviewed for CCPS 12 March 2008.
Preliminary questions [10543]
10791 there is some evidence that immunosuppressive drugs taken for an organ transplantation may be a factor in the development or worsening of the condition under consideration.
2365 the veteran has had an organ transplantation at some time.
10792 the organ transplantation required the veteran to be treated with immunosuppressive drugs. [Default true]
10793 the organ transplantation requiring the veteran to be treated with immunosuppressive drugs was for treatment of an illness or injury which is identifiable. [Default true]
10794 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and VEA service for diabetes mellitus.
28264 as a consequence of the identified illness or injury, the veteran was being treated with immunosuppressive drugs for organ transplantation at the time of the clinical onset of the condition under consideration.
10795 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and VEA service for the clinical onset of diabetes mellitus.
10797 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and operational service for the clinical onset of diabetes mellitus.
or
10798 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and eligible service for the clinical onset of diabetes mellitus.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
10802 as a consequence of the identified illness or injury, the veteran was being treated with immunosuppressive drugs for organ transplantation at the time of the clinical worsening of the condition under consideration.
10796 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and VEA service for the clinical worsening of diabetes mellitus.
10799 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and operational service for the clinical worsening of diabetes mellitus.
or
10800 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and eligible service for the clinical worsening of diabetes mellitus.
Clinical onset and operational service [10797]
2371 the identified illness or injury for which the organ transplant was given is causally related to operational service.
Clinical onset and eligible service [10798]
10264 the identified illness or injury for which the organ transplant was given is causally related to eligible service.
Clinical worsening and operational service [10799]
2371 the identified illness or injury for which the organ transplant was given is causally related to operational service.
10803 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury which required the organ transplantation is causally related.
Clinical worsening and eligible service [10800]
10264 the identified illness or injury for which the organ transplant was given is causally related to eligible service.
10804 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury which required the organ transplantation is causally related.