Improved results in high risk cadaveric kidney transplantation

Journal Article · Tue Jan 01 04:00:00 EST 1980 · Proc. Clin. Dial. Transplant Forum; (United States)

OSTI ID:6711571

Toledo-Pereyra, L H; Baskin, S; McNichol, L; Edford, G; Whitten, J; Allaben, R

In general, cadaver kidney transplantation survival remains at 40-50% for the first year after transplantation. To compare the beneficial effect of a new immunosuppressive protocol to standard therapy (azathioprine and prednisone), we have studied 30 high risk first cadaveric renal allograft recipients who were randomly selected before (Group A, n.15) and after (Group B, n.15) 10/79. At 12 mos, actuarial graft survival of Group B is 75% compared to 46% in Group A. Actuarial patient survival for Group B is 94% for one year compared to 60% in Group A. We feel that these improved results are related to basic changes in our immunosuppressive protocol. These changes consist of: 1. Low doses of azathioprine and prednisolone (less than 1 mg/kg) with rapid reduction to very low levels (less than 0.3 mg/kg); 2. ALG administration at 30 mg/kg/day for 14 times; 3. Rapid placement (one month) on alternate day steroid therapy; 4. Elimination of steroids for the treatment of rejection; 5. Use of ALG (20 mg/kg/day for 10 days) for the treatment of rejection; 6. Use of ALG combined with modified lymph node irradiation for third rejection episodes; and 7. Long-term intermittent ALG administration provided that kidney function continues to be normal. The best immunosuppressive protocol is clearly the one associated with less morbidity and improved quality of life after transplantation. Our current protocol (Group B) provides the best results.

• Research Organization: Department of Surgery, Mt. Carmel Mercy Hospital, Detroit, Michigan
• OSTI ID: 6711571
• Journal Information: Proc. Clin. Dial. Transplant Forum; (United States), Journal Name: Proc. Clin. Dial. Transplant Forum; (United States) Vol. 10; ISSN PCDFD
• Country of Publication: United States
• Language: English

Related Subjects

550600* -- Medicine
551000 -- Physiological Systems
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ADRENAL HORMONES
BODY
CORTICOSTEROIDS
DRUGS
EVALUATION
GLUCOCORTICOIDS
GRAFT-HOST REACTION
HORMONES
HYDROXY COMPOUNDS
IMMUNOSUPPRESSION
IMMUNOSUPPRESSIVE DRUGS
KETONES
KIDNEYS
ORGANIC COMPOUNDS
ORGANS
PATIENTS
PREDNISOLONE
PREGNANES
STEROID HORMONES
STEROIDS
SURVIVAL TIME
TRANSPLANTS