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  • Wilson RE
  • Garovoy MR
  • Strom TB
  • Lowry RP
  • Busch GJ
  • et al.
Transplant Proc. 1981 Mar;13(1 Pt 1):531-2.
  • Filo RS
  • Smith EJ
  • Leapman SB
Transplant Proc. 1981 Mar;13(1 Pt 1):482-90.

A randomized and controlled study was conducted to evaluate the efficacy of adjunctive antithymocyte globulin (ATG) therapy for the treatment of the initial rejection episode in first transplants of Haplo-LRD and cadaveric kidneys. When compared to the control group, which received only standard antirejection treatment (SAT) of steroid pulsing and local irradiation, the adjunctive ATG treatment group demonstrated significantly faster recovery rates from rejection as well as better graft survival rates (67% versus 91%, respectively, p = .01) after the first rejection. ATG treatment did not result in fewer subsequent rejection episodes than SAT but long-term allograft survival rates remained significantly superior to controls for the entire 3-year study period. By avoiding ATG treatment in those patients who never experienced clinical rejection on maintenance immunosuppressive therapy, i.e. nonresponders (32/130--25%), complications associated with excessive immunosuppression were minimized, i.e., graft and patient survival were 100%. The combined results in a 1-year patient survival of 97% and graft survival of 84%. These results suggest that use of ATG therapeutically for the treatment of rejection is efficacious and may be superior to the prophylactic method of ATG treatment in renal transplant patients.

  • Fryd DS
  • Sutherland DE
  • Simmons RL
  • Ferguson RM
  • Kjellstrand CM
  • et al.
Transplant Proc. 1981 Mar;13(1 Pt 1):48-56.
  • Howard RJ
  • Condie RM
  • Sutherland DE
  • Simmons RL
  • Najarian JS
Transplant Proc. 1981 Mar;13(1 Pt 1):473-4.
  • Cosimi AB
Transplant Proc. 1981 Mar;13(1 Pt 1):462-8.
  • Burleson RL
  • Marbarger PD
  • Jermanovich N
  • Brennan AM
  • Scruggs BF
Transplant Proc. 1981 Mar;13(1 Pt 1):339-43.

A prospective double blind crossover study was carried out in 65 patients comparing methylprednisolone (Medrol) and prednisone as immunosuppressive agents in clinical renal transplantation to determine their relative merits vis-a-vis graft survival, hypertension, weight gain, sepsis and patient preference in the posttransplant period. Patients receiving renal allografts were randomly assigned to receive initial treatment with one of the drugs. Once maintenance doses were employed, the drug was switched for a 3-month period. There was no difference in overall graft survival at 1 year, 68% versus 56% (p greater than 0.4), for the two patient groups. Likewise, there was no difference in blood pressure during the maintenance therapy crossover period, mean BP 129/86 during Medrol therapy and 129/86 during prednisone therapy. Overall weight gain was not statistically different with the two drugs, 3.8 kg with prednisone and 2.3 kg with Medrol, p greater than 0.1. However, when Medrol was used in the late posttransplant period, the patient had a significantly smaller weight gain, 0.95 kg versus 3.5 kg with prednisone, p greater than 0.05. The incidence of bacterial sepsis was significantly greater (p less than 0.02) during the early posttransplant period in those patients treated with Medrol. Finally, the majority of patients (65%) had no preference for either drug. Of those with a preference, the majority (69%) preferred Medrol. We conclude that therapy with Medrol does not offer superior graft survival, less hypertension or overriding patient preference but does apparently lead to an increased incidence of bacterial sepsis in the early posttransplant period. Thus it appears that prednisone is the initial drug of choice as an immunosuppressive steroid in clinical renal transplantation.

  • Chan L
  • French ME
  • Oliver DO
  • Morris PJ
Transplant Proc. 1981 Mar;13(1 Pt 1):336-8.
  • Ahonen J
  • Häyry P
  • von Willebrand E
  • Eklund B
  • Lindström BL
  • et al.
Transplant Proc. 1981 Mar;13(1 Pt 1):328-31.
  • Kreis H
  • Mansouri R
  • Descamps JM
  • Dandavino R
  • N'Guyen AT
  • et al.
Kidney Int. 1981 Mar;19(3):438-44 doi: 10.1038/ki.1981.37.

The influence of horse antihuman thymocyte globulin (ATG) on renal allograft survival was assayed between March 1977 and August 1978. Fifty consecutive patients were randomly assigned to the treatment or the control group. Patients in both groups received azathioprine and prednisolone. ATG was added in the experimental group. The daily dosage was such as to maintain the rosette-forming cell (RFC) level at 10% of baseline values. The number of renal failure episodes (RFE's)was significantly lower in the experimental group during the period (1 month) ATG was given than it was in the control group during that same period of time. Two years after transplantation, kidney survival was 79% in the ATG group and 52% in the control group. The amount of steroids necessary to control RFE's was significantly lower in the ATG group. The dosages of ATG used in the experimental group were relatively small (average daily dose, 3.08 +/- 0.26 mg/kg of body wt), and adverse reactions were mild. Blood tolerance was excellent. T-cell monitoring thus appears to be an effective method in evaluating the daily dosage of ATG.

  • Marker SC
  • Simmons RL
  • Balfour HH
  • Balfour HHJr
Transplant Proc. 1981 Mar;13(1 Pt 1):117-9.