alexa Effect of the maintenance immunosuppressive drug regimen on kidney transplant outcome.


Journal of Clinical Toxicology

Author(s): Opelz G

Abstract Share this page

Abstract Renal transplant recipients require long-term maintenance immunosuppression for prevention of graft rejection. To reduce harmful side effects, combinations of immunosuppressive drugs are used. The effect on long-term outcome of different drug regimen has not been established. Over 12,000 kidney recipients who initially received triple-drug immunosuppressive therapy (cyclosporine, steroids, and azathioprine) after transplantation were studied. Graft and patient survival rates were analyzed over a 5-year period in relation to the 1-year immunosuppressive regimen. Five-year graft survival was significantly higher in 1270 patients who were changed from triple-drug therapy to steroid-free maintenance with cyclosporine (with or without the addition of azathioprine) (87 +/- 1\%) than in 8024 patients who remained on triple-drug therapy (76 +/- 1\%, P < 0.0001), 2829 patients on cyclosporine and steroids (79 +/- 1\%, P < 0.0001), and 830 patients on steroids and azathioprine (63 +/- 2\%, P < 0.0001). Patient survival was also significantly higher in patients on steroid-free maintenance (P < 0.0001). Steroid-free patients received significantly higher doses of cyclosporine than patients on regimens containing steroids (P < 0.0001). The immunosuppressive maintenance protocols that are currently most widely used appear to give suboptimal results. We suggest that discontinuation of steroid therapy should be attempted in renal transplant recipients after they have experienced several months of stable graft function on triple-drug immunosuppression.
This article was published in Transplantation and referenced in Journal of Clinical Toxicology

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version