Medizinische Universität Graz - Research portal
Selected Publication:
Laufer, G; Laczkovics, A; Wollenek, G; Schreiner, W; Kober, I; Wolner, E.
Incidence and severity of acute cardiac allograft rejection with two different low-dose cyclosporine maintenance protocols.
Ann Thorac Surg. 1988; 46(4): 382-388.
Doi: 10.1016/S0003-4975(10)64647-4
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- Keeling Ingeborg
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- Abstract:
- Currently cyclosporine (CyA) represents the main immunosuppressive agent used after cardiac transplantation and usually is administered in combination with prednisone and/or azathioprine for prevention of graft rejection. From March, 1984, to August, 1987, 53 patients underwent orthotopic heart transplantation for terminal-stage heart disease at the Second Department of Surgery, University of Vienna. All patients received CyA in increasing dosage (3 mg/kg to 6-10 mg/kg) postoperatively according to renal function, obtaining a trough high-pressure liquid chromatographic whole-blood target level of 200 to 400 ng/ml at the end of the first week. CyA was subsequently tapered to 100 to 150 ng/ml after 6 months. From March, 1984, through April, 1986, maintenance immunosuppression was carried out with a double-drug regimen of CyA and azathioprine. Since May, 1986, a triple-drug schedule was applied with CyA, azathioprine, and prednisone. Under triple-drug therapy, the incidence of mild, moderate (p less than 0.0001), and severe (p = 0.05) allograft rejection proven by endomyocardial biopsy decreased significantly with a corresponding increase of absent (p less than 0.0001) rejection. Freedom from moderate, severe, and lethal graft rejection, number of rejection episodes per patient after 1 year (double drug, 1.0, versus triple drug, 2.5), and patient survival disclosed significant improvement for recipients of the triple-drug regimen. Both groups had the same incidence of infectious complications; freedom from death by infection after 1 year was 90% versus 91% (double versus triple drug, p = 0.20).(ABSTRACT TRUNCATED AT 250 WORDS)
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Adolescent -
- Adult -
- Azathioprine - administration and dosage
- Child - administration and dosage
- Cyclosporins - administration and dosage
- Drug Administration Schedule - administration and dosage
- Drug Therapy, Combination - administration and dosage
- Graft Rejection - drug effects
- Heart Transplantation - drug effects
- Humans - drug effects
- Immunosuppression - methods
- Middle Aged - methods
- Myocardium - pathology
- Prednisone - administration and dosage