[Antilymphocytic sera versus azathioprine, combined with cyclosporin and steroids, in liver transplant. Comparison of the results at the intensive care unit and 2 years' follow-up].
The use of anti-lymphocyte globulins (ATG, ALG, OKT3) for the control or organ rejection in humans, has been of major importance both in preventing and treating organ rejection resistant to other treatments. We present here the results of our immunosuppression protocol using two different therapeutic associations. To the first group consisting of 29 patients, low doses of cyclosporine, steroids and anti-lymphocyte globulins were given, and to another group of 11 patients azathioprine was given together with cyclosporine and steroids at the same doses as in the first group. We want to point out that the incidence of acute rejections was similar in both groups (17.2% vs 18.1%) immediately after surgery and a greater incidence of rejections at a later time during the follow up period in the group treated with azathioprine (34.4% vs 54.6%). The incidence of chronic rejections was similar in both groups (10.3% vs 8.9%). During the follow up period, the incidence of infections was higher in the group treated with azathioprine (13.7% vs 36.4%) as well as bacteremia episodes (17.2% vs 45.4%) (p less than 0.1). We also want to highlight that patients with graft complications (primary graft rejection) suffered infections (p less than 0,001) and had a higher mortality rate (p less than 0,05) in association to the infection.
Cisneros Alonso
C
C
Departmento de Medicina Intensiva, Hospital 12 de Octubre, Universidad Complutense, Madrid.
Díaz Castellanos
M A
MA
Montero Castilló
A
A
Moreno González
E
E
Calleja González
J
J
Gómez Gutiérrez
M
M
Sánchez-Izquierdo Riera
J A
JA
García Fuentes
C
C
D000328:Adult; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use*; D003524:Cyclosporins / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000187:drug effects*; D006801:Humans; D007165:Immunosuppression Therapy; D007362:Intensive Care Units; D016031:Liver Transplantation; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged
D000961:Antilymphocyte Serum; D003524:Cyclosporins; D001379:Azathioprine; D008775:Methylprednisolone
Sueros antilinfocitarios frente a azatioprina, en asociación con ciclosporina y esteroides, en el trasplante hepático. Comparación de resultados en UCI y seguimiento de dos años.