When an organ is transplanted, the immune system of the recipient will most likely recognize it as foreign tissue and attack it. The destruction of the organ will, if untreated, end in the death of the recipient.
To prevent that, immunosuppressant drugs are used to inhibit the reaction of the immune system. The downside is that with such a deactivated immune system, the body is very vulnerable to opportunistic infections, even those usually considered harmless. Also, prolonged use of immunosuppressants increases the risk of cancer.
Immunosuppression is also used to counteract autoimmune diseases, such as rheumatoid arthritis or Crohn's disease, to prevent the immune system from attacking healthy parts of the body.
Cortisone was the first immunosuppressant identified. The more effective azathioprine was identified in 1959, but it was not until the discovery of cyclosporine in 1970 that transplant surgery found a sufficiently powerful immunosuppressive.
For some of these conditions, all affected persons will be severely immunocompromised: for others, such as HIV infection, the spectrum of disease severity due to disease or treatment stage will determine the degree to which the immune system is compromised.
Frequently, the immune response of immunocompromised persons to these vaccine antigens is not as good as that of immunocompetent persons; higher doses or more frequent boosters may be required, although even with these modifications, the immune response may be suboptimal.
When exposed to a vaccine preventable disease such as measles, severely immunocompromised children should be considered susceptible regardless of their history of vaccination.
Immunocompromised pet owners should be willing to seek veterinary care early in the clinical course of illness in their pet.
Immunocompromised persons should avoid contact with bird droppings, although an increased incidence of suitcases has not been reported among immunosuppressed persons, and enteric pathogens, such as Salmonella and Campylobacter spp, apparently are rarely acquired from birds.
In lieu of having their dogs vaccinated, immunocompromised persons, especially those with advanced disease, should avoid exposing themselves and their dogs to environments known to represent a source of B bronchiseptica (eg, boarding kennels, dog shows, or any situation in which dogs from several sources are housed together).
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