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Klinische Wochenschrift

, Volume 65, Issue 18, pp 879–884 | Cite as

Graft survival and long-term renal function after sequential conventional cyclosporin a therapy in cadaver kidney transplantation — a prospective randomized trial

  • R. Grundmann
  • U. Hesse
  • P. Wienand
  • C. Baldamus
  • W. Arns
Originalien

Summary

In a prospective randomized trial 50 renal transplant patients (group A) received a sequential course of 14 days conventional immunosuppression (Lymphocytoglobuline (ALG), azathioprine, steroids) and cyclosporin and steroids thereafter, while 50 patients (group B) received the conventional immunosuppression for 7 days followed by cyclosporin and steroids. In the latter group ALG was tolerated for the whole period while in the first group conversion from conventional to cyclosporin A therapy had to be performed after a mean of 11 days, due to ALG intolerance. Actual patient survival rates 1 year posttransplant were 100% in both groups and graft survival rates 96% in group A and 86% in group B (P<0.05). There was a mean dialysis frequency per patient of 0.7±2.0 in group A and 1.8±3.4 in group B (P=0.064). Serum creatinine 1 year posttransplant was 1.8±0.8 mg/dl in group A and 2.2±1.4 in group B. A total of 58 patients had a serum creatinine of less than 2 mg/dl at the time of conversion to cyclosporin. These patients had a significantly better graft survival rate (98.3%) and serum creatinine 1 year posttransplant (1.6±0.5 mg/dl) than the 40 patients with a serum creatinine of more than 2 mg/dl at the time of conversion (85%; 2.4±1.4 mg/dl), indicating that a delayed onset of cyclosporin therapy might benefit the kidney in the immediate posttransplant period when it is susceptible to nephrotoxicity due to the damage from hypothermic storage.

Key words

Cyclosporin Conventional immunosuppression Long-term renal function 

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Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • R. Grundmann
    • 1
  • U. Hesse
    • 1
  • P. Wienand
    • 1
  • C. Baldamus
    • 2
  • W. Arns
    • 3
  1. 1.Chirurgische Universitätsklinik Köln-LindenthalGermany
  2. 2.I. Medizinische UniversitätsklinikGermany
  3. 3.I. Medizinische Klinik des Krankenhauses MerheimGermany

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