PMID: 8587292Dec 1, 1995Paper

Influence of treatment with cyclosporine, azathioprine and steroids on chronic allograft failure. The Collaborative Transplant Study

Kidney International. Supplement
Gerhard Opelz

Abstract

The efficacy of different immunosuppressive regimens was analyzed in a multicenter series of cadaver kidney transplants reported to the Collaborative Transplant Study. Induction therapy with steroid-free cyclosporine regimens resulted in significantly better graft survival than induction including a combination of cyclosporine and steroids (P < 0.001) or azathioprine and steroids (P < 0.0001). Because immunosuppressive protocols frequently changed during the first post-transplant year, graft survival from the first to the fifth year was used to analyze the efficacy of long-term maintenance immunosuppressive regimens. Steroid-free maintenance with cyclosporine resulted in significantly better five-year graft survival (P < 0.0001) and patient survival (P < 0.01) than maintenance with steroid-containing cyclosporine regimens or maintenance on azathioprine and steroids without cyclosporine (P < 0.0001). Steroid-free patients received significantly higher doses of cyclosporine than patients on steroid-containing cyclosporine regimens. These results suggest that steroid-free maintenance immunosuppression with cyclosporine should be attempted in patients with an uncomplicated posttransplant course.

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