An increased incidence of late acute rejection episodes in cadaver renal allograft recipients given azathioprine, cyclosporine, and prednisone

L. E. Wrenshall, A. J. Matas, D. M. Canafax, D. I. Min, R. J. Sibley, D. L. Dunn, W. D. Payne, D. E R Sutherland, J. S. Najarian

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

We studied the incidence of biopsy-proven, acute rejection episodes occurring after 1 year posttransplant in cadaver renal allograft recipients. The 328 patients evaluated were given three immunosuppressive drug protocols. Group I (transplanted 9/80-6/84) (n=75) received azathioprine, prednisone (P), and antilympho-blast globulin; group II (transplanted 9/80–6/84) (n=83) received cyclosporine and P; group III (transplanted 7/84-12/86) (n=170) received ALG, AZA, CsA, and P (sequential therapy). The incidence of first acute rejection episodes occurring up to 1 year posttransplant was 55% in group I and 35% in groups II and III. The incidence of late (>1 year) acute rejection episodes was 6.5% in group I, 2.5% in group II, and 9.5% in group III (group II vs. III, P=0.02). In group III, 50% of the late rejections were first, 44% second, and 6% third. The primary etiologies of this increased incidence of late acute rejection may have included subtherapeutic CsA levels and lower P doses. Sequential immunosuppressive therapy has been shown to be advantageous in the first posttransplant year. However, unless adequate immunosuppression is maintained, this approach can be associated with a significantly increased incidence of late acute rejection.

Original languageEnglish (US)
Pages (from-to)233-237
Number of pages5
JournalTransplantation
Volume50
Issue number2
DOIs
StatePublished - Aug 1990

Fingerprint Dive into the research topics of 'An increased incidence of late acute rejection episodes in cadaver renal allograft recipients given azathioprine, cyclosporine, and prednisone'. Together they form a unique fingerprint.

  • Cite this