A randomized study comparing three cyclosporine-based regimens in cadaveric renal transplantation: results at 7 years

Autor: F Mastrangelo, Marco Castagneto, P Altieri, V. Cambi, G.B Piredda, A Tarantino, U. Valente, C Ponticelli, G P Segoloni, Stefano Federico, F Pisani, M Salvadori, G Rizzo, M Messina, Mario Carmellini, L. Arisi, G. Montagnino, Maria Laura Cossu
Rok vydání: 1998
Předmět:
Zdroj: Transplantation Proceedings. 30:1729-1731
ISSN: 0041-1345
DOI: 10.1016/s0041-1345(98)00407-2
Popis: AFTER the worldwide adoption of cyclosporine (CsA) for maintenance immunosuppression, a striking improvement in renal transplant survival has been obtained. Recipients of first cadaver allografts commonly achieve 1-year graft survival approaching 90% with low patient mortality. Yet, in spite of the large experience accumulated with CsA, we still do not know which CsA-based protocol is better in the long-term. Although CsA was administered alone in clinical transplantation at the beginning of its use, steroid-free immunosuppression has not been accepted in most transplant centers because of the risk of nephrotoxicity associated with the large dose of CsA required for successful immunosuppresion and the increased risk of acute rejection, which could expose patients to chronic graft dysfunction in the long term. The results obtained using an association between CsA and steroids (double therapy) or CsA, steroids, and azathioprine (triple therapy) did not show any significant differences in either the patient or graft survival rates or in the incidence of drug-related complications. We recently reported the results of a randomized trial simultaneously comparing the three treatment schemes. We have now reanalyzed the data by extending the follow-up at 7 years after transplantation.
Databáze: OpenAIRE
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