[Graft rejection after changing from cyclosporin A therapy to conventional treatment in kidney transplant patients].

Hundred and twenty live patients after the first transplantation of the kidney from a decreased donor with satisfactory graft function, treated with cyclosporine A combined with prednisone or combined with prednisone or combined with prednisone and azathioprine were divided into three groups: A--20 patients changed during the 6th-9th month after transplantation to conventional azathioprine-prednisone treatment. B--68 patients switched to this treatment during the 10h-15th month following transplantation. K--37 patients who were not switched to other treatment during the mentioned period. Within 3 months after the switched rejection develop in 21% of the patients in group A and 20% patients in group B. The incidence of rejections during a comparable period in group K was significantly lower (3%), as compared with group A and insignificantly lower (14%), as compared with group B. The majority of rejections was documented by biopsy but no morphological difference was found between rejections which developed in patients switched and not switched to other treatment. It was striking that there was a difference, though insignificant, in the sensitivity of rejections to antirejection treatment with methylprednisolone after switch to a different preparation: in group A 25%, in group B 37% and in group K 80%. Patients in group A with rejection after the switch had developed a rejection even before the switch significantly more frequently (in 75%) than in group B (in 7%) and these rejections led significantly more frequently to loss of the graft.