Cyclosporin A in children with persistent renal transplant rejection and progressively deteriorating graft function

The effect on renal function and growth of switching from azathioprine to cyclosporin A (CyA) was prospectively evaluated in ten children with persistent renal transplant rejection. Progression of renal insufficiency during CyA therapy was compared with that before using CyA. Prednisone administration decreased after CyA was introduced and although growth retardation persisted, height velocity improved significantly. Renal function stabilized in seven patients treated with CyA for a variable time period, and four of these children remain off dialysis 0.44-1.42 years later. Renal biopsies were obtained in seven children when they were converted from azathioprine to CyA. The response to CyA could not be predicted from renal morphology or clinical features.