Alternative antirejection treatment with steroids or antilymphoblast globulin in renal transplant patients receiving cyclosporine.

An alternative antirejection protocol using corticosteroids or ALG for reversal of initial acute rejections was studied during a 2-year period in 112 mismatched renal transplant recipients receiving CsA. The majority of patients were cadaver transplant recipients. Thirty-five initial episodes of acute rejection occurred; twelve patients with early or histologically severe rejection were treated with ALG and 23 patients with late, nonsevere rejection received corticosteroid therapy. The overall success rate was approximately 90%, with 21 of 23 corticosteroid-treated patients and ten of 12 ALG-treated patients responding to therapy. The two treatment modalities did not differ with respect to subsequent hospital admissions for fever, second rejections, graft survival, or patient survival. Corticosteroid-treated patients realized significant cost savings and required a shorter hospital stay when compared to ALG-treated patients. An alternative antirejection treatment protocol may be highly effective, safe, and cost beneficial.