CYCLOSPORIN-A AND STEROID-THERAPY IN 66 CADAVER KIDNEY RECIPIENTS

Abstract

From 9-18 mo. ago, 66 patients were given 67 randomly matched cadaveric kidneys with cyclosporin A and steroid therapy. Of the recipients, 9 were undergoing retransplantation. The over-all kidney survival rate do date has been 77.6%; 78.8% of the recipients are dialysis-free. The patient mortality in this learning phase was 13.3%. Nephrotoxicity, hepatotoxicity and other side-effects of cyclosporin A could usually be dealt with by dosage adjustments, making feasible the chronic use of this agent. One B cell immunoblastic sarcoma was encountered which was monoclonal. It was not responsible for death. Another patient had a perforation of the intestine from a lymphoproliferative reaction in which the B cells were polyclonal. After jejunal resection a year ago, there were no further complications. This lesion was not classified as a lymphoma. Both lymphoproliferative lesions were associated with a rise in antibody to viral capsid antigen of Epstein-Barr virus. Results of the study verify the effectiveness and relative safety of cyclosporin A with steroids for immunosuppression in human recipients of cadaveric kidneys.