Marchioro, TL and Axtell, HK and LaVia, MF and Waddell, WR and Starzl, TE
(1964)
The role of adrenocortical steroids in reversing established homograft rejection.
Surgery, 55 (3).
412 - 417.
ISSN 0039-6060
Abstract
Renal homotransplantation was performed in 8 dogs. Antirejection therapy with azathioprine (BW 57-322, Imuran) was given in doses of 2 to 7.5 mg. per kilogram per day. Evidence of rejection developed in all animals from 4 to 32 days following transplantation. When rejection had been established by at least 2 successive elevations of the BUN level, intramuscular injections of prednisolone (50 to 200 mg. per day) were added to the preexisting azathioprine therapy. Seven of the 8 animals had a favorable response evidenced by a falling BUN level, increased urine volumes, and decreasing proteinuria. Gastrointestinal bleeding was a serious complication in 6 of the 8 dogs. It was a direct or contributing cause of death in all 6. The rationale for the use of prednisolone in homotransplantation is discussed. From these experiments it would appear to be a valuable adjunct in reversing established rejection when added in large doses to preexisting antirejection therapy with azathioprine. Vigorous antacid therapy is indicated to prevent gastrointestinal ulceration and bleeding. © 1964.
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