Infections in kidney, heart, and liver transplant recipients on cyclosporine

Abstract

O UR study involves 216 patients trans- planted at the University of Pittsburgh from 1978 to 1983 (Table I).This includes 64 kidney patients on cyclosporine (CsA), of which 21 were in a randomized trial of CsA, with 17 patients on azathioprine (AZA).I Since the latter was a small number, 59 renal patients on AZA from 1978 to 1980 are included for comparison.Except for the immunosuppressive drugs, all renal transplant recipients received comparable management largely from the same surgical team.In addition, from 1981 to 1983, we followed 33 heart and 43 liver transplant recipients who were all on CsA.This drug was first introduced in Pittsburgh in March 1981.A preliminary report of infections in these groups has been published. 2This article provided additional patients, data, and follow-up material. MATERIALS AND METHODSAll renal groups were followed for at least 6 months.Heart and liver patients were followed for a minimum of 3 months.The mean duration of follow-up for the latter 2 groups were 277 and 221 days, with a range of 90-400 and 90-594 days.Most patients received intravenous methylprednisolone I day prior to surgery.CsA was given according to Starzl et al. l On the day of surgery, 17.5 mg/kg/day was given orally, and attempts were made to reduce the dose to 3-10 mg/kg/day, Patients on AZA were begun on 5 mg/kg/day, with maintenance of 2.5 mg/kg/day.All patients on CsA and AZA also received prednisone.Patients on CsA received somewhat less cumulative prednisone than those on AZA.' The 3 types of transplant patients on CsA were on similar regimens, except 6 of 33 cardiac recipients also received antithymo-