Q: My 23 year old sister has been diagnosed to have CRF one year back. She is on dialysis right now. Doctors are planning for kidney transplant (donor is my father) but she is having the following problems: 1. She has epilepsy for last 10 years. 2. She has recently been implanted with a permanent pace maker. 3. Right now she is having high blood pressure and is on Minoxidil 5mg. Is it safe to have this medicine? Kindly let us know if her transplant will be successful as one doctor has said that immunosuppressant medicines will not allow the epileptic medicine to work on her properly and she will have seizures after transplant. Please suggest how can we deal with situation?

A:Epilepsy makes the matter slightly complicated but in no way does it preclude your sister from getting a transplant. I am assuming that her seizures are controlled on the medication. The anti-seizure drugs do interact with anti- rejection drugs but that will require slight adjustment of dosages and close monitoring of levels. These things, although complex, are not difficult to achieve provided your sister remains adherent to doctors advice. Nor should pacemaker pose a problem as far her heart has been completely investigated and she does not have coronary artery disease. You have not listed what other anti-hypertensives is she on. But minoxidil, although effective, is not a desirable medication as it has frequent side-effects including unwanted hair growth, leg swelling, sometimes fluid build-up around heart, increased heart rate. Since there are lot of medications available that are safer than minoxidil, it has fallen out of favour. Only situation it is used is either if everything else has failed or cost is a factor.