NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What is the treatment for T-cell mediated (acute cellular) rejection?

Antithymocyte globulin and alemtuzumab
High dose steroids and increased levels of maintenance immunosuppression
IVIG and plasmapheresis
Rituximab and steroids

The correct answer is: High dose steroids and increased levels of maintenance immunosuppression

For T-cell mediated (acute cellular) rejection, the most appropriate treatment involves high dose steroids and increased levels of maintenance immunosuppression. This approach helps to suppress the immune response that is targeting the transplanted organ. High dose steroids are effective in reducing inflammation and suppressing the activity of T-cells that are responsible for the rejection process. Increasing the levels of maintenance immunosuppression helps to further dampen the immune response, protecting the transplanted organ from further damage. Option A (Antithymocyte globulin and alemtuzumab) is not the first-line treatment for T-cell mediated rejection but may be considered in refractory cases. Option C (IVIG and plasmapheresis) is more commonly used for antibody-mediated rejection rather than T-cell mediated rejection. Option D (Rituximab and steroids) is typically used for antibody-mediated rejection involving B-cell activity.