Comparison of immunosuppression therapy following heart transplantation

pretransfusion/azathioprine/atg/prednisone versus cyclosporine/prednisone

G. R. Barnhart, Mitchell Goldman, A. Hastillo, S. Szentpetery, T. Wolfgang, J. Thompson, T. Mohanakumar, M. R. Katz, S. Rider, J. Hanrahan

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Since the introduction of cyclosporine in heart transplantation, the search for the ideal combination of immunosuppressive agents continues. Between January 1983 and February 1985, 32 patients have been randomized prospectively to either one of two immunosuppressive regimens: one includes pretransplant transfusion, prednisone, azathioprine and rabbit anti-thymocyte globulin [Group I, n = 14], the other includes cyclosporine and prednisone [Group II, n = 18]. There were no differences between Group I and II in relation to age distribution, indications for transplantation, preoperative serum creatinine, length of follow-up, mortality or number of rejection episodes per patient. However, there was a statistically significant increase in the incidence of serious infections in Group I compared to Group II patients, and also in Group II of the incidence of systemic hypertension (p<0.001), of symptomatic pericardial effusion (p<0.05) and impaired renal function (p<0.02). Adding cyclosporine to azathioprine immunosuppression is effective in treating ongoing rejection in patients not previously treated with cyclosporine. In conclusion, patients treated with azathioprine and prednisone (Group I) develop a greater number of serious infections, but both groups had a similar incidence of rejection. The development of renal dysfunction and hypertension in patients treated with cyclosporine continues to be of concern and may preclude its use as an effective long-term immunosuppressive agent in heart transplant recipients.

Original languageEnglish (US)
Pages (from-to)381-384
Number of pages4
JournalJournal of Heart Transplantation
Volume4
Issue number4
StatePublished - Dec 1 1984
Externally publishedYes

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Azathioprine
Heart Transplantation
Prednisone
Immunosuppression
Cyclosporine
Immunosuppressive Agents
Incidence
Therapeutics
Renal Hypertension
Antilymphocyte Serum
Pericardial Effusion
Age Distribution
Infection
Creatinine
Transplantation
Rabbits
Hypertension
Kidney
Mortality
Serum

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Comparison of immunosuppression therapy following heart transplantation : pretransfusion/azathioprine/atg/prednisone versus cyclosporine/prednisone. / Barnhart, G. R.; Goldman, Mitchell; Hastillo, A.; Szentpetery, S.; Wolfgang, T.; Thompson, J.; Mohanakumar, T.; Katz, M. R.; Rider, S.; Hanrahan, J.

In: Journal of Heart Transplantation, Vol. 4, No. 4, 01.12.1984, p. 381-384.

Research output: Contribution to journalArticle

Barnhart, GR, Goldman, M, Hastillo, A, Szentpetery, S, Wolfgang, T, Thompson, J, Mohanakumar, T, Katz, MR, Rider, S & Hanrahan, J 1984, 'Comparison of immunosuppression therapy following heart transplantation: pretransfusion/azathioprine/atg/prednisone versus cyclosporine/prednisone', Journal of Heart Transplantation, vol. 4, no. 4, pp. 381-384.
Barnhart, G. R. ; Goldman, Mitchell ; Hastillo, A. ; Szentpetery, S. ; Wolfgang, T. ; Thompson, J. ; Mohanakumar, T. ; Katz, M. R. ; Rider, S. ; Hanrahan, J. / Comparison of immunosuppression therapy following heart transplantation : pretransfusion/azathioprine/atg/prednisone versus cyclosporine/prednisone. In: Journal of Heart Transplantation. 1984 ; Vol. 4, No. 4. pp. 381-384.
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