Risks of Hyperbaric Oxygen Therapy Post-Transplant

[Falkenhayn]

Hyperbaric oxygen therapy will be recommended to some post-transplant patients to improve slow wound healing, especially if they have indolent diabetic ulcers which take a long time to heal. However, one study has shown that hyperbaric oxygen treatment may have negative effects when combined with a certain immunosuppressive medication, cyclosporine:

"Basic Clin Pharmacol Toxicol. 2006 Feb;98(2):150-4.

Investigation of the effect of hyperbaric oxygen on experimental cyclosporine nephrotoxicity.

Atasoyu EM, et al.

Hyperbaric oxygen interacts with drugs which patients use concurrently with hyperbaric oxygen treatment, which may cause in potentiation or inhibition of both therapeutic and toxic effects. We examined the effect of hyperbaric oxygen therapy on experimental cyclosporine A nephrotoxicity. The study comprised four groups of rats: a control group, a cyclosporine A group (25 mg/kg/day intraperitoneally for four days), a hyperbaric oxygen group (60 min. every day for four days at 2.5 atmospheric pressure), and a cyclosporine A+hyperbaric oxygen group (CsA 25 mg/kg/day intraperitoneally for four days+hyperbaric oxygen for 60 min. every day for four days at 2.5 atmospheric pressure). Hyperbaric oxygen did not alter biochemical parameters. Cyclosporine A increased serum urea and serum creatinine levels and decreased creatinine clearance. In the cyclosporine A+hyperbaric oxygen group serum urea level increased more than in the cyclosporine A group. Cyclosporine A increased tubular epithelial cell apoptosis and necrosis score values. The numbers of apoptotic cells in proximal tubule epithelial cells in the cyclosporine A+hyperbaric oxygen group were significantly higher than those of the cyclosporine A group. We recommend that renal functions of the patients receiving cyclosporine A should be monitored during hyperbaric oxygen therapy."

The second to the last sentence states the main point, which is that when hyperbaric oxygen treatment is combined with cyclosporine, the number of cells in the kidney which had burst is much higher than when cyclosporine is used alone.