Impact of cyclosporine on cadaveric renal transplantation: a summary statement.
CsA has now been used in this country for about four years and has been widely available for a little more than one year. Both the experience of those centers that have been using it longest, and total US national experience, suggest that CsA is now, with the sole exception of recipients matched for both HLA-DR antigens, the immunosuppressive of choice for all cadaveric renal allografts, conferring approximately a 10% advantage in graft survival. The advantages of CsA seem particularly apparent in the management of high-risk patients such as those over 50 years old and those with diabetes. CsA appears to reduce the frequency of rejection episodes and to permit reduction of steroid dosage. These factors, together with the improved graft survival rate, may contribute to a substantially higher rate of patient rehabilitation. The role of transfusion and HLA matching in association with CsA remains somewhat controversial. While large multicenter studies show the continued importance of both transfusion and optimal HLA matching, it has been argued that avoidance of pretransplant transfusions has avoided presentation of potential recipients, and that simplification of matching requirements has saved money and has permitted speedier transplantation of patients, favoring improved rehabilitation. Careful monitoring of the experience with this major new immunosuppressive agent over the next several years may answer these remaining questions.
D001803:Blood Transfusion; D002102:Cadaver; D002986:Clinical Trials as Topic; D003524:Cyclosporins / Q000627:therapeutic use*; D005260:Female; D006085:Graft Survival / Q000187:drug effects*; D006680:HLA Antigens; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012306:Risk
D003524:Cyclosporins; D006680:HLA Antigens