Benefits of Quadruple Immunosuppressive Therapy in Recipients of Living Related Donor Kidneys A Review of 855 Operations
| Autor: | Barber Wh, D A Laskow, Curtis Jj, Bruce O. Barger, Sharon L. Hudson, Robert S. Gaston, Mark H. Deierhoi, Bruce A. Julian, Arnold G. Diethelm |
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| Rok vydání: | 1992 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Azathioprine Gastroenterology Risk Factors Prednisone Internal medicine medicine Humans Child Survival rate Aged Antilymphocyte Serum Retrospective Studies medicine.diagnostic_test business.industry Mortality rate Graft Survival Immunosuppression Retrospective cohort study Middle Aged Kidney Transplantation Tissue Donors Histocompatibility Surgery Survival Rate Cyclosporine Female business Tissue typing Immunosuppressive Agents Follow-Up Studies Research Article medicine.drug |
| Zdroj: | Annals of Surgery. 215:606-617 |
| ISSN: | 0003-4932 1988-1991 |
| DOI: | 10.1097/00000658-199206000-00007 |
| Popis: | Eight hundred fifty-five living related donor transplant recipients were analyzed according to 15 potential risk factors with regard to patient and graft survival according to immunosuppression. Group I, 1968 to 1983, (n = 440 patients) received azathioprine and prednisone; group II, 1984 to 1987, (n = 229 patients) received triple therapy--azathioprine, prednisone, and cyclosporine; and group III, 1988-1991, (n = 186 patients), quadruple therapy--azathioprine, prednisone, cyclosporine, and Minnesota antilymphocyte globulin. Three important risk factors included immunosuppression, tissue typing, and race. Groups II and III had improved allograft survival over group I (p = 0.03). Patients with two haplotype matches had similar survival in all three groups. Kidney survival in one-haplotype-matched recipients improved in group II and was equal to that of the two-haplotype-matched patients in group III. Cyclosporine improved allograft survival in both races when combined with azathioprine and prednisone. Quadruple therapy improved early survival in one-haplotype black patients, even though long-term results remained better in whites. Cyclosporine did not improve graft survival in two-haplotype recipients. The addition of cyclosporine and quadruple therapy did not increase morbidity and mortality rates. |
| Databáze: | OpenAIRE |
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