[Change from treatment with cyclosporin A to conventional treatment in kidney transplantation].

Patients after a first transplantation of the kidney from a dead donor treated with cyclosporin A in combination with one, two or three drugs were switched to conventional treatment with azathioprine and prednisone. Fifty-two patients were switched to the new treatment 11-15 months after transplantation (group I), 9 patients after 6-10 months (groups II), 17 patients after 16-30 months (groups III). Group I was compared with 21 patients where no switched was made after 11-15 months (group IV). The authors did not reveal any change in the survival of grafts nor in the number of rejections during the three-month period following the switch. Survival of grafts in patients with rejection was after two years following the switch significantly lower than in patients without rejection, the loss of grafts, however, did not differ as compared with patients who suffered a rejection during a comparable period but were not switched to conventional therapy. The interval of the switch after transplantation did not influence the incidence of rejections. Rejections after the switch cannot be reliably foreseen from the level of cytotoxic anti-HLA antibodies or previous repections before the switch.