Ranitidine and cimetidine in renal transplantation: a clinical trial

Sixteen patients were randomized for treatment with ranitidine and seventeen for treatment with cimetidine to prevent the appearance of upper gastrointestinal (UGI) complications after renal transplantation. The two operated groups were comparable with regard to age, sex, number of pre-operative blood transfusions, and HLA match. All patients were treated with a similar immunosuppressive regime, consisting of azathioprine and methylprednisolone, and underwent endoscopic examination ten and thirty days following surgery. In the second endoscopy an entirely normal condition was observed in 11 and 12 cases in the oesophagus, 4 and 4 cases in the stomach and 13 and 12 cases in the duodenum in the two groups of 16 and 17 patients respectively. Except for one uncomplicated prepyloric ulcer in the cimetidine group, the remaining endoscopic findings were mild in intensity. There were, however, significantly more rejection episodes in the cimetidine group than in the ranitidine group. Ranitidine seems to be a safe drug in transplant patients, but the high incidence of rejection episodes in the cimetidine group is a cause for concern.