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Benefits of quadruple immunosuppressive therapy in recipients of living related donor kidneys A review of 855 operations Diethelm AG; Laskow DA; Hudson SL; Deierhoi MH; Barber WH; Barger BO; Julian BA; Gaston RS; Curtis JJAnn Surg 1992[Jun]; 215 (6): 606-16; discussion 616-7Eight hundred fifty-five living related donor transplant recipients were analyzed according to 15 potential risk factors with regard to patient and graft survival according to immunosuppression. Group I, 1968 to 1983, (n = 440 patients) received azathioprine and prednisone; group II, 1984 to 1987, (n = 229 patients) received triple therapy--azathioprine, prednisone, and cyclosporine; and group III, 1988-1991, (n = 186 patients), quadruple therapy--azathioprine, prednisone, cyclosporine, and Minnesota antilymphocyte globulin. Three important risk factors included immunosuppression, tissue typing, and race. Groups II and III had improved allograft survival over group I (p = 0.03). Patients with two haplotype matches had similar survival in all three groups. Kidney survival in one-haplotype-matched recipients improved in group II and was equal to that of the two-haplotype-matched patients in group III. Cyclosporine improved allograft survival in both races when combined with azathioprine and prednisone. Quadruple therapy improved early survival in one-haplotype black patients, even though long-term results remained better in whites. Cyclosporine did not improve graft survival in two-haplotype recipients. The addition of cyclosporine and quadruple therapy did not increase morbidity and mortality rates.|*Kidney Transplantation/mortality[MESH]|*Tissue Donors[MESH]|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Antilymphocyte Serum/administration & dosage[MESH]|Azathioprine/administration & dosage[MESH]|Child[MESH]|Cyclosporine/administration & dosage[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Graft Survival[MESH]|Histocompatibility[MESH]|Humans[MESH]|Immunosuppressive Agents/*administration & dosage[MESH]|Male[MESH]|Middle Aged[MESH]|Prednisone/administration & dosage[MESH]|Retrospective Studies[MESH]|Risk Factors[MESH]|Survival Rate[MESH] |
