Sequential discontinuation of azathioprine and prednisone in renal transplantation.
We report the time course of rejections in 110 patients of first cadaver kidney grafts entered into a randomized controlled trial of induction ALG vs continuous IV CyA, with both groups receiving Aza for 30 days and Pred for 3 months. There was no difference in 1-year graft or patient survival in the two induction regimens. Despite a slight delay in time to first rejection, the number, severity, and outcome of rejections were the same in both. Fifty percent of patients never had a rejection, and 80% of these were on CyA monotherapy at 1 year vs only 22% in patients with rejections. Thirty-five percent had a rejection in the first month, and one fourth of these had a repeat in the second month. The risk of graft loss was 10% with a first, 38% with a second, and 50% with a third rejection. First rejections occurring after 30 days rarely caused graft loss and rejection after 90 days proved to be unusual.
Gulanikar
A C
AC
Transplant Service, Victoria General Hospital, Halifax, Nova Scotia, Canada.
Sungurtekin
U
U
MacDonald
A S
AS
Belitsky
P
P
Bitter-Suermann
H
H
Cohen
A
A
Jindal
K
K
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D001707:Biopsy, Needle; D002648:Child; D003524:Cyclosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007262:Infusions, Intravenous; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies
D000961:Antilymphocyte Serum; D003524:Cyclosporins