Withdrawal of cyclosporine in renal transplant recipients with acute tubular necrosis improves renal function. 2000

D Kahn, and J F Botha, and M D Pascoe, and A R Pontin, and J Halkett, and V Tandon
Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa. kannemey@uctgsh1.uct.ac.za

In this study, patients with acute tubular necrosis (ATN) after renal transplantation were prospectively randomized to either conventional immunosuppression or withdrawal of cyclosporine and replacement with anti-thymocyte globulin (ATG). The patients treated with cyclosporine withdrawal and ATG had a significantly shorter duration of ATN (8.9 +/- 1.5 vs 10.8 +/- 1.4 days; P < 0.05) and better renal function (mean serum creatinine on day 5 postoperatively: 740 +/- 49 vs 918 +/- 73 micromol/l; P < 0.05). The incidence of acute rejection was lower in the patients with cyclosporine withdrawal and ATG. In conclusion, cyclosporine is toxic to the renal allograft with ATN, and withdrawal of cyclosporine shortens the duration of ATN and improves renal function.

UI MeSH Term Description Entries
D007166 Immunosuppressive Agents Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging. Immunosuppressant,Immunosuppressive Agent,Immunosuppressants,Agent, Immunosuppressive,Agents, Immunosuppressive
D007683 Kidney Tubular Necrosis, Acute Acute kidney failure resulting from destruction of EPITHELIAL CELLS of the KIDNEY TUBULES. It is commonly attributed to exposure to toxic agents or renal ISCHEMIA following severe TRAUMA. Lower Nephron Nephrosis,Acute Kidney Tubular Necrosis,Lower Nephron Nephroses,Nephron Nephroses, Lower,Nephron Nephrosis, Lower,Nephroses, Lower Nephron,Nephrosis, Lower Nephron
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D005260 Female Females
D006084 Graft Rejection An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. Transplant Rejection,Rejection, Transplant,Transplantation Rejection,Graft Rejections,Rejection, Graft,Rejection, Transplantation,Rejections, Graft,Rejections, Transplant,Rejections, Transplantation,Transplant Rejections,Transplantation Rejections
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000961 Antilymphocyte Serum Serum containing GAMMA-GLOBULINS which are antibodies for lymphocyte ANTIGENS. It is used both as a test for HISTOCOMPATIBILITY and therapeutically in TRANSPLANTATION. ATGAM,Antilymphoblast Globulins,Antilymphocyte Antibodies,Antilymphocyte Globulin,Lymphocytotoxic Antibodies,Anti-Thymocyte Globulin,Antilymphocyte Immunoglobulin,Antithymocyte Globulin,Antithymoglobulin,Lymphocyte Immune Globulin, Anti-Thymocyte Globulin,Lymphocyte Immune Globulin, Anti-Thymocyte Globulin (Equine),Pressimmune,Anti Thymocyte Globulin,Anti-Thymocyte Globulins,Antibodies, Antilymphocyte,Antibodies, Lymphocytotoxic,Antibody, Antilymphocyte,Antibody, Lymphocytotoxic,Antilymphoblast Globulin,Antilymphocyte Antibody,Antilymphocyte Globulins,Antilymphocyte Immunoglobulins,Antilymphocyte Serums,Antithymocyte Globulins,Antithymoglobulins,Globulin, Anti-Thymocyte,Globulin, Antilymphoblast,Globulin, Antilymphocyte,Globulin, Antithymocyte,Globulins, Anti-Thymocyte,Globulins, Antilymphoblast,Globulins, Antilymphocyte,Globulins, Antithymocyte,Immunoglobulin, Antilymphocyte,Immunoglobulins, Antilymphocyte,Lymphocyte Immune Globulin, Anti Thymocyte Globulin,Lymphocytotoxic Antibody,Serum, Antilymphocyte,Serums, Antilymphocyte

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