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[Clinical studies on 228 renal transplants]
H Sugimoto1, N Akiyama, O Otsubo
1Department of Organ Transplantatin, University of Tokyo, Japan.
Nihon Geka Gakkai Zasshi
|January 1, 1989
Summary
Cyclosporine-based immunosuppression significantly improves patient and graft survival rates in renal transplantation. This highlights the importance of effective immunosuppression in reducing rejection and infection for better transplant outcomes.
Area of Science:
- Nephrology
- Transplantation Immunology
- Immunosuppression Therapy
Background:
- Renal transplantation outcomes are influenced by immunosuppressive regimens and histocompatibility.
- Acute rejection and infections are critical factors affecting patient and graft survival.
- Traditional immunosuppressive protocols had limitations in preventing graft loss and complications.
Purpose of the Study:
- To evaluate the impact of different immunosuppressive strategies on patient and graft survival in renal transplantation.
- To compare the efficacy of cyclosporine-based regimens versus older protocols.
- To identify key factors influencing transplant success and failure.
Main Methods:
- Analysis of 228 renal transplants categorized into seven groups based on immunosuppressive regimen and histocompatibility.
- Comparison of patient survival and graft survival rates across different treatment arms.
- Assessment of the incidence and severity of acute rejection and infections.
Main Results:
- Higher patient and graft survival rates were observed in groups receiving cyclosporine (CYA), HLA identical sibling (Id Sib), and donor-specific transfusion with anti-lymphocyte globulin (DST.ALG).
- Cyclosporine-based cadaveric transplantation (CYA.Cad) showed improved outcomes compared to conventional methods (Conv.Cad).
- Lower incidence and severity of acute rejection were noted in Id Sib, CYA, DST.ALG, and CYA.Cad groups.
- The Conv.Cad group experienced the highest incidence of infections, with increased fatal infections in ALG, Non-DST.Non-ALG, and Conv.Cad groups.
Conclusions:
- Acute rejection and infection are significant determinants of renal transplant survival.
- Cyclosporine-based immunosuppression offers superior patient and graft survival rates compared to older regimens.
- Enhanced cadaveric renal transplantation utilizing cyclosporine is recommended to improve national transplant rates.