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Long-term results of cyclosporin A therapy in children

J Brodehl1, A Bökenkamp, P F Hoyer

  • 1Medical School Hannover, Children's Hospital, Department of Pediatric Nephrology and Metabolic Diseases, Germany.

Journal of the American Society of Nephrology : JASN
|June 1, 1992
PubMed

Insights

Cyclosporin A (CsA) offers better long-term patient and graft survival after pediatric renal transplantation compared to azathioprine (AZA). While CsA showed lower graft function, it did not progressively decline over time.

Area of Science:

  • Pediatric Nephrology
  • Transplantation Immunology
  • Pharmacology

Background:

  • Long-term outcomes of immunosuppression in pediatric renal transplantation are crucial.
  • Cyclosporin A (CsA) and azathioprine (AZA) are standard immunosuppressants.
  • Assessing the long-term effectiveness and tolerability of CsA in children is important.

Purpose of the Study:

  • To compare the long-term effectiveness and tolerability of CsA versus AZA in pediatric renal transplant recipients.
  • To evaluate patient and graft survival rates, rejection episodes, and graft function.

Main Methods:

  • Retrospective analysis of 32 children treated with CsA and low-dose prednisolone.
  • Comparison with 34 children treated with AZA and high-dose prednisolone.
  • Both groups had functioning grafts for at least 5 years post-transplantation.

Main Results:

  • Overall patient and graft survival rates were significantly better in the CsA group.
  • The CsA group experienced more late acute reversible rejection episodes (6 vs. 2).
  • Graft function was lower in CsA recipients but showed no progressive decline.

Conclusions:

  • CsA demonstrates superior long-term patient and graft survival in pediatric renal transplantation.
  • Despite lower graft function, CsA's stability mitigates concerns about progressive loss.
  • CsA is a viable long-term immunosuppressive option for children post-renal transplant.

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