Cyclosporin A in renal transplantation: a prospective randomized trial.
Cyclosporin A combined with prednisone was compared with standard immunosuppressive therapy (antilymphoblast globulin, prednisone, and azathioprine) in a prospective randomized trial of 100 mismatched, living related donor and cadaveric renal transplants. The results demonstrated cyclosporin A plus prednisone to be an effective immunosuppressive regimen for renal transplantation. The actuarial graft survival at 1 year was 93% for patients treated with cyclosporin A and 81% for patients treated with conventional immunosuppression. Patient survival was 98% for the cyclosporin A group and 100% for the conventional group. Cyclosporin A-treated patients had fewer rejection episodes and fewer infections complications including a marked decrease in the incidence of posttransplant cytomegalovirus infection. The side effects of cyclosporin A were mild, but nephrotoxicity caused by cyclosporin A was frequent and significant. Nephrotoxicity was reversible and managed by decreasing the daily cyclosporin A dose. It is concluded that the combination of cyclosporin A plus prednisone provides an excellent alternate immunosuppressive regimen for renal transplants as compared with conventional therapy. The consequences of long-term administration of cyclosporin A are at present unknown.
D000293:Adolescent; D000328:Adult; D000961:Antilymphocyte Serum / Q000494:pharmacology; D001379:Azathioprine / Q000494:pharmacology; D002986:Clinical Trials as Topic; D003524:Cyclosporins / Q000009:adverse effects / Q000494:pharmacology*; D003586:Cytomegalovirus Infections / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000187:drug effects; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011241:Prednisone / Q000494:pharmacology; D011446:Prospective Studies; D011897:Random Allocation; D014181:Transplantation Immunology / Q000187:drug effects
D000961:Antilymphocyte Serum; D003524:Cyclosporins; D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone