<prompt> A 45-year-old man develops end-stage renal disease due to diabetic nephropathy. He undergoes a renal transplant with a kidney donated from his sister. Which of the following immune suppression therapies are usually used to prevent rejection in renal transplant patients?splenectomy and irradiationplasmapheresis and steroidscyclosporine and steroidsazathioprine and plasmapheresis  <response>: Cyclosporine A blocks production of inter-leukin-2 IL-2 by helper-inducer CD4 T cells. It works alone but is more effective in combination with glucocorticoids. The use of cyclosporine has improved 1-year cadaveric survival rates to the 80-85 range. Side effects include hepatotoxicity, hirsutism, tremor, and gingival hyperplasia, but only the nephrotoxicity presents a serious management problem. 