Immunosuppression by Cyclosporin A in human renal transplant recipients

Nine renal transplant recipients were treated with Cyclosporin A (CyA). Seven of them were high risk patients (diabetics or above 55 years of age) receiving cadaveric grafts. Two were recipients of related grafts and azathioprine had been shown to give them severe GI symptoms. Secondary anuria developed presumably due to nephrotoxicity caused by CyA in 2 of the recipients of cadaveric kidneys. The patients were converted to conventional immunosuppressive drugs and after 2-3 weeks, renal function had recovered in both patients. Seven patients have been maintained on a combination of CyA and oral prednisolone. Four of these patients experienced one or more rejection episodes, all were reversible on treatment with methylprednisolone. Two patients had episodes of increased serum creatinine due to nephrotoxicity by CyA. Recovery occurred when the dose was reduced. Other side effects observed were: Hirsutism (3 patients), gingival hyperplasia (1), tremor (2) and leukopenia (1). Four patients had infectious complications and one died of cytomegalovirus pneumonia. Six patients are well having serum creatinine levels ranging from 89-181 mumol/1, 1 to 11 months after transplantation.