Antilymphocyte globulin with a small dose of cyclosporine A and prednisone as the induction of immunosuppression in renal allograft recipients.
In attempt to avoid a detrimental synergism between CsA and renal ischemia in the immediate postoperative period, ALG (425 lymphocytotoxic units/kg) with small doses of CsA (6-8 mg/kg) and P were applied as the initial immunosuppressive therapy in 14 recipients of cadaveric kidneys. ALG was administered for 5 to 14 days and 2 days before withdrawing ALG, Aza (2 mg/kg) was introduced. Results of this protocol were compared with those of 19 pts treated with CsA (12 mg/kg) and P. All the pts were followed for at least 12 months. The duration of posttransplant anuria was significantly reduced in the ALG/CsA/P group (p < 0.02). The sCr concentration after 12 months of observation was significantly lower (p < 0.05), no alterations in urinalysis were detected, the number of hypertensive pts was decreased. The acute rejection rates were equivalent in both groups, however 3 of 4 rejections in ALG/CsA/P group were resistant to steroids and occurred in pts with shortened period of ALG administration. The one year patient and graft survival in the ALG/CsA/P and control groups were respectively: 78.5%, 71.4% and 89.4%, 78.9%. Severe infectious complications in the group treated with ALG/CsA/P occurred in pts who were subsequently treated with OKT3.
Boratyńska
M
M
Department of Nephrology, Medical Academy, Wrocław, Poland.
Szepietowski
T
T
Szewczyk
Z
Z
Szydłowski
Z
Z
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D000961:Antilymphocyte Serum / Q000009:adverse effects / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D007511:Ischemia; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016853:Muromonab-CD3 / Q000009:adverse effects / Q000627:therapeutic use; D010689:Phlebitis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D015996:Survival Rate; D013921:Thrombocytopenia / Q000453:epidemiology / Q000209:etiology; D014184:Transplantation, Homologous
D000961:Antilymphocyte Serum; D016853:Muromonab-CD3; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone