Lung transplantation without the use of antilymphocyte antibody preparations.
Survival, infection, and rejection rates and functional data are reported in 35 lung recipients treated with triple-drug immunosuppression without antilymphocytic antibody therapy. Early mortality (less than 60 days) was 6%. Thirty recipients (86%) are alive, with a mean follow-up period of 16 months (range, 1 to 36 months). Actuarial survival was 91% at 1 year and 83% at 2 years. Thirty-seven infections occurred in 24 patients. Actuarial freedom from infection was 61% at 3 months and 27% at 1 year. Only one patient died of infection (aspergillosis). Thirty-six episodes of acute rejection were treated in 23 patients. Time to first rejection was 14 +/- 7.8 days. Actuarial freedom from acute rejection was 36% at 2 months. Significant functional improvement was evident in all operative survivors. Pulmonary function and exercise performance data in patients without bronchiolitis obliterans remain stable 1 year after transplantation. We conclude that the use of triple-drug immunosuppression without antilymphocytic antibody preparations in lung transplantation provides effective immunosuppression with a low risk of serious infectious complications.
Kriett
J M
JM
Department of Surgery, University of California, San Diego 92103.
Smith
C M
CM
Hayden
A M
AM
Robert
R
R
Parthasarathy
R
R
Kapelanski
D P
DP
Jamieson
S W
SW
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D001379:Azathioprine / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007239:Infections / Q000209:etiology; D016040:Lung Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011241:Prednisone / Q000008:administration & dosage; D015996:Survival Rate
D000961:Antilymphocyte Serum; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone