Four years' experience with cyclosporin A in pediatric kidney transplantation.
From 1982 to 1987 sixty-three children were treated with cyclosporin A and low dose prednisolone after kidney transplantation. Patient survival rate at 4 years after transplantation was 98.3%, survival rate of living related grafts 100% (n = 10), and survival rate of cadaveric grafts 73% (n = 53). Adequate cyclosporin blood levels were achieved in all children with a dosage regimen related to body surface area. Major concerns during the observation period were the loss of glomerular filtration rate from 51.8 to 40.5 ml/min/1.73 m2, a hypertension rate of 77.8%, and hyperuricemia. Cyclosporin A-side effects were mild. Infections occurred in 11.1%. Growth retardation in prepubertal children improved by 0.74 standard deviations of normal height, and in pubertal children by 0.51. We conclude that cyclosporin A treatment in children enables excellent long term graft survival rates with improved growth rehabilitation, however, the prevention of the cyclosporin associated nephrotoxicity and hypertension remains the major problem.
Hoyer
P F
PF
Department of Pediatric Nephrology and Metabolic Disorders, Medical School Hannover, FRG.
Offner
G
G
Oemar
B S
BS
Brodehl
J
J
Ringe
B
B
Pichlmayr
R
R
D000293:Adolescent; D001827:Body Height; D001835:Body Weight; D056486:Chemical and Drug Induced Liver Injury; D002648:Child; D002675:Child, Preschool; D003524:Cyclosporins / Q000009:adverse effects / Q000097:blood / Q000494:pharmacology; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology; D008297:Male; D012044:Regression Analysis; D013997:Time Factors
D003524:Cyclosporins