One hundred and twenty-nine kidney allograft patients who received cyclosporine(CsA) and prednisone from January, 1984 to December, 1989 were compared with 72 kidney allograft patients who received conventional immunosuppresion from October, 1973
to
December, 1983. In CsA treated group, 120 patients were donated from living related donors and 9 from living unrelated donors. The mean age of recipients was 32.0 years. The male to female ratio was 4.2 : 1. In Aza treated group, 63 patients were
donated from living related donors and 8 from living unrelated donors. One cadaveric donor was used. The mean age of recipients was 31.5% years. The male to female ratio was 7.0 : 1. Demographic differences(age, sex, sourse of donor kidney, HLA
mismatch) between CsA group and Aza group were comparble. This article describes the complications seen in both treatment groups.
1) The statistical difference of incidence of acute rejection was not significant between two groups(Aza : 38.8%, CsA; 31.0%).
2) There were no significant differences in graft and patient survival rates according to immunosuppressive agents. In CsA treated group, graft and patient survival rates were 90.7%, 92.2% at 1 year, 87.66%, 89.9% at 2 years, 85.8%, 88.1% at 3
years,
83.3%, 86.9% at 4 years, 73.3%, 81.4% at 5 years respectively. In Aza treated group, graft and patient survival rates were 83.2%, 84.2% at 1 year, 76.7%, 80.1% at 2 years, 73.5%, 78.5% at 3 years, 68.8%, 75.6% at 4 years, 65.9% 72.9% at 5 years,
respectively.
3) The incidence infectious complications was 62.5% in Aza treated group and 43.4% in CsA treated group. The statistical differance of infectious complications were not significant between two groups(P>0.05). Thirteen cases of bacterial
pneumonias
were
seen in Aza treated group and 17 cases of herpes infections were seen in CsA treated group.
4) In Aza treated group, incidence of liver dysfuction was 8.3% and 2 cases resulted in death due to progressive liver failure. In CsA treated group, incidence of liver dysfuction was 14.4% and 5 cases resulted in death due to progressive liver
failure.
5) The incidence of nephrotoxicity in CsA treated group was 29.7%.
6) 19 patients(26.3%) in Aza treated group had urologic complications compared to 14 patients (7.7%) in CsA treated group.
7) Three patients in the each group developed cancers during follow up period. In Aza treated group, 3 cases of cancers were a hepatocellular carcinoma, a gastric adenocarcinoma, a melanoma on left sole. In CsA treated group, 3 cases of cancers
were a
basal cell carcinoma on medial canthal fold of the right eye, two Kaposis sarcomas. Among them 5 patients expired and one patient is still alive with good renal function.
8) Three months posttransplant, the mean daily prednisone dose(±SD) in the CsA group was 11.3±6.2 mg/day, compared with 16.2±11.4 mg/day in the Aza group(p<0.05).
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