DETRIMENTAL EFFECT OF CYCLOSPORINE ON INITIAL FUNCTION OF CADAVER RENAL ALLOGRAFTS FOLLOWING EXTENDED PRESERVATION Results of a randomized Prospective Study
| Autor: | Marlene Goormastic, Donald Steinmuller, Andrew C. Novick, Robert J. Cunningham, Caroline Buszta, Hwei Ho-hsieh, Diane Steinhilber, Stevan B. Streem |
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| Rok vydání: | 1986 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Time Factors Adolescent Renal function Cyclosporins Kidney Function Tests Nephrotoxicity Random Allocation chemistry.chemical_compound Azathioprine medicine Humans Transplantation Homologous Prospective Studies Child Prospective cohort study Acute tubular necrosis Antilymphocyte Serum Transplantation Kidney Creatinine Renal ischemia business.industry Graft Survival Organ Preservation Middle Aged medicine.disease Kidney Transplantation Surgery medicine.anatomical_structure chemistry Prednisone Female business Immunosuppressive Agents |
| Zdroj: | Transplantation. 42:154-158 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/00007890-198608000-00010 |
| Popis: | We report herein the results of a randomized prospective trial comparing maintenance cyclosporine (CsA)-prednisone immunosuppression to a regimen of azathioprine-prednisone-antilymphocyte globulin (ALG) in cadaver renal transplant recipients. Fifty-six patients were entered into this study with 31 assigned to the ALG group and 25 to the CsA group. These two groups were well matched for most major determinants of graft outcome and the mean renal preservation time was 37 hr in each group. The incidence of acute tubular necrosis (ATN) was high in both groups (58% ALG, 72% CsA, NS). There were five cases of primary nonfunction in the CsA group and only one in the ALG group (P = .05). Of the kidneys that functioned, the mean serum creatinine nadir (1.5 vs. 2.2 mg/dl, P = .06) and the mean number of days to reach the serum creatinine nadir (24.2 vs. 43.3 days, P = .03) were both less in the ALG group. The actuarial one-year graft survival rate in the ALG and CsA groups is 78% and 48%, respectively (P less than .05). This difference is mainly due to the large number of primary nonfunctioning grafts in the latter group, which we attribute to the effect of CsA's nephrotoxicity superimposed on renal ischemia incurred prior to transplantation. These data emphasize that, in order to realize the full benefit of CsA in cadaver transplantation, renewed emphasis must be placed on minimizing ischemic renal damage. |
| Databáze: | OpenAIRE |
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