Experience with three immunosuppressive protocols in living related donor kidney transplantation

Abstract

Three protocols of immunosuppression were used in 105live related donar kidney transplantations depending on availability of drugs. Three protocols were used on three groups of patients. Group 1 (10 patients) received conventional immunosuppression therapy. Group 11 (74 patients) received triple therapy with low dose cycloporin A, 5mg/kg, tailed off at 6 to 8 months. Group 111 (21 patients) received triple therapy with high dose cyclosporine A, 10mg/kg from day 90 and tailed off at 1 year. Groups I received 2.5 mg/kg azathioprine daily. Group 11 2 mg/kg and Group 111 2mg/kg reduced to 1.5 mg/kg at day 90. Group 1 and 11 were given daily prednisolone 80 mg, reduced to 10 mg at day 30. Group 111 received dailyprednisolone 30 mg reduced to 20 mg at day 30, 10mg at day 90. Intra -operative -methyl prednisolone (1000mg intravenously0was given to group 1, 500mg to groups 11 and 111. The mean follow up period was group 1-34 months (range 4-65) Group 11-23 months(0.5 to 58) Group 111 - 4.2 months (0.5 to 8) Rejection episodes in the first six months were group 1,8(80%) group 11, 53(72%), group 111, 9 (43%). Number on antihypertensives at 6 months were group 1 (none), group 11 -30 (40%), group 111 -8 (73%) The group on a high dose of cyclosporine. A had significantly less episodes of rejection and a higher incidence of hypertension requiring anti hypertensives at 6 months. The latter may be attributed to the use of high dose cyclospirin A. When patient and graft survival in the different groups were compared using the log rank test, no significant difference was observed.