title: Management of the renal allograft recipient: immunosuppressive protocols for long-term success.
abstract: To determine the benefits of long-term cyclosporine (CsA) immunosuppression, renal allograft recipients were randomly assigned to a protocol of either: CsA+azathioprine (Aza)+prednisone (TD), or to a protocol in which CsA was discontinued from the regimen of Aza+prednisone (CsA D/C). With a mean follow-up of nearly 7 years since transplantation, 30/47 (64%) CsA D/C and 27/45 (60%) TD had functioning allografts. Although long-term survivals were similar, hazards of the CsA D/C protocol were evident (40% rate of acute rejection following CsA D/C). Conversely, continued CsA in the TD protocol provided the opportunity for prednisone reduction, or even complete prednisone withdrawal in selected patients. A TD protocol which can provide equivalent long-term success, and eventually lower or omit prednisone, is preferable to a protocol of CsA D/C.
authors.affiliation: Transplantation Unit of the General Surgical Services, Massachusetts General Hospital, Boston 02114.
authors.forename: F L
authors.initials: FL
authors.lastname: Delmonico
authors.forename: N
authors.initials: N
authors.lastname: Tolkoff-Rubin
authors.forename: H
authors.initials: H
authors.lastname: Auchincloss
authors.forename: W W
authors.initials: WW
authors.lastname: Williams
authors.forename: L T
authors.initials: LT
authors.lastname: Fang
authors.forename: H
authors.initials: H
authors.lastname: Bazari
authors.forename: M L
authors.initials: ML
authors.lastname: Farrell
authors.forename: A B
authors.initials: AB
authors.lastname: Cosimi
mesh_terms: D000208:Acute Disease; D001379:Azathioprine / Q000008:administration & dosage; D002908:Chronic Disease; D016572:Cyclosporine / Q000008:administration & dosage; D006084:Graft Rejection; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016030:Kidney Transplantation / Q000401:mortality; D011241:Prednisone / Q000008:administration & dosage
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone