Results of the Minnesota Randomized Prospective Trial of Cyclosporine Versus Azathioprine-Antilymphocyte Globulin for Immunosuppression in Renal Allograft Recipients

摘要: Between September 26, 1980 and June 8, 1984, 246 splenectomized, transfused renal allograft recipients were randomized to treatment with either cyclosporine (CsA)-prednisone (n = 131) or azathioprine (Aza)-prednisoneantilymphocyte globulin 115). On December 31, actuarial patient survival rates at three years 896 in the CsA group 90% Aza group, corresponding graft 82% 79% (statistically insignificant differences). The results also compared separately diabetic nondiabetic patients of related cadaver donor grafts; only subgroup kidneys differences significantly different between CsA- Aza-treated patients. incidence posttransplant acute tubular necrosis was similar (33/0 v 27%), but duration longer than (15.7 ± 18.4 7.7 ±3.0 days). Rejection episodes infections (particularly CMV) occurred less frequently Mean serum creatinine levels higher (2.0 0.6 1.5 0.5 mgldL). Treatment hypertension hyperkalemia required more CsA-treated Initial mean hospitalization time shorter (15.6 9.5 19.8 10.7 In group,19% switched 35% had added their regimen a concomitant lowering dose because nephrotoxicity. our trial are variance those others that not patients, primarily conventionally-treated rate other trials. advantages (fewer rejection episodes, fewer infections, hospitalization) outweigh disadvantages (higher creatinine, hypertension), thus we believe it should be used most recipients, perhaps combination so lower can side effects minimized-a currently evaluating.