Withdrawal of cyclosporine in renal transplant recipients with acute tubular necrosis improves renal function.
In this study, patients with acute tubular necrosis (ATN) after renal transplantation were prospectively randomized to either conventional immunosuppression or withdrawal of cyclosporine and replacement with anti-thymocyte globulin (ATG). The patients treated with cyclosporine withdrawal and ATG had a significantly shorter duration of ATN (8.9 +/- 1.5 vs 10.8 +/- 1.4 days; P < 0.05) and better renal function (mean serum creatinine on day 5 postoperatively: 740 +/- 49 vs 918 +/- 73 micromol/l; P < 0.05). The incidence of acute rejection was lower in the patients with cyclosporine withdrawal and ATG. In conclusion, cyclosporine is toxic to the renal allograft with ATN, and withdrawal of cyclosporine shortens the duration of ATN and improves renal function.
Kahn
D
D
Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa. kannemey@uctgsh1.uct.ac.za
Botha
J F
JF
Pascoe
M D
MD
Pontin
A R
AR
Halkett
J
J
Tandon
V
V
D000328:Adult; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D007683:Kidney Tubular Necrosis, Acute / Q000276:immunology* / Q000473:pathology*; D008297:Male; D011183:Postoperative Complications; D012086:Reoperation
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine