Methyldopa therapy and outcome in cadaveric renal transplantation

Methyldopa therapy for hypertension after renal transplantation could affect graft outcome adversely, since methyldopa inhibits suppressor cells. To study effects of methyldopa on transplant outcome, we analyzed prospective data on 1,648 hypertensive, first-allograft recipients; 545 patients used methyldopa and 1,103 patients did not. One-year graft functional survival was 66% and 67% for all patients using and not using methyldopa respectively. No increased acute rejection occurred related to methyldopa. During the one to six years of follow-up, no adverse effects on graft survival could be attributed solely to methyldopa except that graft survival among white recipients using methyldopa was diminished late after transplantation (P less than .05). Patient survival was not affected by methyldopa. Azathioprine and prednisone therapy may avert the suppressor cell inhibition by methyldopa. Its effect on kidney transplant outcome is not significant except in whites late in the course of graft function; methyldopa use when clinically indicated appears safe.