Recipient lymphocyte sensitivity to methylprednisolone affects cadaver kidney graft survival.
In 42 recipients of mixed-lymphocyte-culture (MLC) incompatible cadaver kidneys and conventional immunosuppressive treatment (azathioprine and steroids) the concentrations of methylprednisolone suppressing the in-vitro response of pretransplant lymphocytes to phytohaemagglutinin by 50% (ED50) were determined. 1-year graft survival was significantly higher in 21 recipients with methylprednisolone ED50 values below the median than in 21 patients with higher than median ED50s (86% v 29%; p less than 0.0002). Thus, the steroid sensitivity of recipients strongly influences the survival of MLC-mismatched kidneys. In 42 transplant recipients treated with cyclosporin and steroids, the effect of steroid sensitivity was also apparent (1-year graft survival 76% and 57% for recipients with low and high ED50, respectively), though not significant. Determination of the sensitivity to steroids may be valuable in determining which recipients can be given HLA-DR-mismatched kidneys and may serve as a guideline for determining the dose of steroids to be used.
Langhoff
E
E
Ladefoged
J
J
Jakobsen
B K
BK
Platz
P
P
Ryder
L P
LP
Svejgaard
A
A
Thaysen
J H
JH
D002102:Cadaver; D002478:Cells, Cultured; D003524:Cyclosporins / Q000494:pharmacology; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D066298:In Vitro Techniques; D016030:Kidney Transplantation; D007959:Lymphocyte Culture Test, Mixed; D008214:Lymphocytes / Q000187:drug effects*; D008775:Methylprednisolone / Q000494:pharmacology*; D010835:Phytohemagglutinins / Q000494:pharmacology; D011239:Prednisolone / Q000494:pharmacology; D013997:Time Factors
D003524:Cyclosporins; D010835:Phytohemagglutinins; D011239:Prednisolone; D008775:Methylprednisolone