Conversion of stable renal allografts at one year from cyclosporin A to azathioprine: a randomized controlled study

Transpl Int. 1990 May;3(1):19-22. doi: 10.1007/BF00333197.

Abstract

Seventy-seven stable, nondiabetic, cadaveric renal transplants were randomized at 1 year to convert from cyclosporin A to azathioprine or to continue on cyclosporin A. Prednisolone was increased twofold during the period of conversion, and there was a 3-week overlap period during which azathioprine and cyclosporin A were given. No grafts were lost due to rejection related to conversion, but 9 of the 33 patients who were randomized to convert experienced rejection episodes and 6 were returned to cyclosporin A. Conversion to azathioprine resulted in a drop in creatinine and improvement in blood pressure control. In the group randomized to stay on cyclosporin A, 6 patients had to be subsequently converted to azathioprine because of cyclosporin A toxicity in spite of well-controlled plasma levels. The creatinine levels after successful conversion remained stable whereas those of the patients continuing on cyclosporin A showed a progressive decline. We conclude that conversion from cyclosporin A to azathioprine can be achieved safely. Progressive deterioration in graft function with continuing cyclosporin A therapy does occur and should be taken as an indication for conversion.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Azathioprine / therapeutic use*
  • Creatinine / blood
  • Cyclosporins / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Graft Rejection / drug effects*
  • Humans
  • Kidney / metabolism
  • Kidney Transplantation / immunology*
  • Male
  • Prednisolone / pharmacology
  • Randomized Controlled Trials as Topic
  • Time Factors

Substances

  • Cyclosporins
  • Prednisolone
  • Creatinine
  • Azathioprine