Cyclosporine--lessons from the first 20 years.
The introduction of cyclosporine in clinical practice led to a dramatic increase in long-term graft survival. At the Transplantation Center of the University of Rome La Sapienza, the survival rate at 5, 10, and 20 years was 35%, 22%, and 20% in the precyclosporine era and 75%, 60%, and 45%, respectively, after the use of cyclosporine-based immunosuppressive therapy. However, because of the nephrotoxicity of this, drug efforts are being made to reduce or avoid the use of calcineurin inhibitors. We advocate tailoring of immunosuppression to a minimal level on the basis of immunologic tests that permit a quantitative and qualitative evaluation of regulatory and effector cells.
Cortesini
R
R
Columbia University Department of Pathology, New York, NY 10032, USA. rc238@columbia.edu
D002102:Cadaver; D016572:Cyclosporine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005190:Family; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D019520:Living Donors / Q000706:statistics & numerical data; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data
D007166:Immunosuppressive Agents; D016572:Cyclosporine