[Combined immunosuppression (cyclosporin, azathioprine, methylprednisolone) in patients at immunological risk after kidney transplantation].

Animal experiments have demonstrated a synergistic immunosuppressive effect when using the combination of ciclosporin (CS) and azathioprine (AZA) as immunosuppressant. On this basis these drugs were used in patients considered to be at high risk for immunological complications. Group I (immunological risk patients) consisted of 63 patients with a second or third graft and/or elevated cytotoxic antibodies above 30% against the test panel. In addition to the basic immunosuppressive therapy (CS) and methylprednisolone (MP), AZA was given in the first 2 weeks following transplantation. Group II (historical control) summarized immunological risk patients with conventional immunosuppressive therapy (AZA/MP). The IIIrd group with 28 patients on the above mentioned immunological risk were treated with CS and MP only. The results revealed a 2-year actuarial graft survival rate of 68% (groups I) versus 40% (group II) versus 52% (group III). There were no differences in WBC and platelet counts or in infectious complications. No malignancy was noticed.