Cyclosporin A effective therapy for fifty-two cadaver kidney recipients.

Abstract

Fifty-two consecutive patients receiving cadaveric renal transplants were prescribed cyclosporin A and steroid therapy. Three of the recipients underwent re-transplantation and two of the patients were grafted with kidneys shipped from the United States. One year actuarial patient and graft survival rate with no exclusions were 94.2 percent and 81.6 percent, respectively, this rate being significantly better than results in case of the conventional combination of azathioprine, steroid and antilymphocyte globulin. The role of HLA-DR matching on cyclosporin A treatment was studied. One year actuarial graft survival rates of two HLA-DR matched and one HLA-DR matched were 91.7 percent and 78.9 percent, respectively. To assess the effects of cyclosporin A in the management of patients with acute tubular necrosis, the patients were divided into two groups, in terms of whether or not hemodialysis treatment was required for acute tubular necrosis. Although in the present protocol, cyclosporin A administration was begun before the operation, no significant differences in the graft survivals were evident between the two groups. Nephrotoxicity, hepatotoxicity and other side-effects of cyclosporin A could usually be dealt with by dosage adjustments, making feasible the chronic ingestion of this agent. The exceptional effectiveness and safety of cyclosporin A were evident throughout these early trials.