Early or delayed onset of cyclosporine by sequential immunosuppression?
In a prospective randomized trial, 57 renal transplant patients (group A) received a sequential course of 14 days conventional immunosuppression (anti-lymphocyte globulin (ALG), azathioprine and steroids) and cyclosporine and steroids thereafter, while 57 patients (group B) received the conventional immunosuppression for 2 days followed by cyclosporine and steroids. In group A, ALG was tolerated for a mean of 7.8 days while, in group B, conventional therapy had to be changed to cyclosporine therapy after a mean of 2.1 days due to ALG intolerance. Patient survival rates 1 and 2 years after transplantation were 95% and 92% in group A and 96% and 92% in group B, and graft survival rates were 79% and 79% in group A and 89% and 82% in group B. In group A, the dialysis frequency in the second, third and fourth weeks after transplantation was significantly higher than in group B. Serum creatinine 1 year post-transplant showed no significant difference between the two groups.
Wienand
P
P
Chirurgische Universitätsklinik Köln-Lindenthal, Köln, FRG.
Schröder
T
T
Baldamus
C
C
D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000627:therapeutic use; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D016019:Survival Analysis; D013997:Time Factors
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D001379:Azathioprine