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The use of cyclosporin A and prednisone in cadaver kidney transplantation

Starzl, TE and Weil, R and Iwatsuki, S and Klintmalm, G and Schröter, GP and Koep, LJ and Iwaki, Y and Terasaki, PI and Porter, KA (1980) The use of cyclosporin A and prednisone in cadaver kidney transplantation. Surgery Gynecology and Obstetrics, 151 (1). 17 - 26. ISSN 0039-6087

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Abstract

Eighteen patients were treated with primary cadaveric renal transplantation using cyclosporin A therapy, and four more patients underwent cadaveric retransplantation. Eleven of the 22 recipients were conditioned with lymphoid depletion before transplantation, using thoracic duct drainage or lymphapheresis for two to eight and one-half weeks. cyclosporin A was begun a few hours before grafting. The other 11 patients were pretreated wtih cyclosporin A for from one day to 18 days. After transplantation, the majority of patients in both subgroups of 11 had rejection develop, but in most, the immunologic process was readily controlled with relatively small dosages of prednisone. After follow-up periods of two to four and one-half months, one patient has died of the complications of a coronary artery reconstruction that was not related to the transplantation. Another graft was lost from rejection, and a third organ was removed because of ureteral necrosis. Nineteen of the original 22 cadaveric kidneys are functioning, including 17 of the 18 kidneys given to patients who were undergoing transplantation for the first time. The only loss in the latter group of 18 patients was in the patient who died after an open heart operation. Results of these studies have shown that cyclosporin A is a superior and safe immunosuppressive drug but that, for optimal use in cadaveric transplantation, it usually should not be given alone. Steroid therapy greatly amplified the value of cyclosporin A. Unless major delayed morbidity develops which is not obvious so far, this drug combination should permit revolutionary advances ion the transplantation of all organs. Other adjunct to the cyclosporin A-steroid combination, including lymphoid depletion techniques, will require further investigation.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Starzl, TEtes11@pitt.eduTES11
Weil, R
Iwatsuki, S
Klintmalm, G
Schröter, GP
Koep, LJ
Iwaki, Y
Terasaki, PI
Porter, KA
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 12 September 1980
Date Type: Publication
Journal or Publication Title: Surgery Gynecology and Obstetrics
Volume: 151
Number: 1
Page Range: 17 - 26
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0039-6087
Other ID: uls-drl:31735062114198, Starzl CV No. 453
Date Deposited: 08 Apr 2010 17:07
Last Modified: 14 Oct 2017 11:55
URI: http://d-scholarship.pitt.edu/id/eprint/3839

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