Improved Results of Cadaver Renal Transplantation with Azathioprine, Prednisone and Antilymphoblast Globulin

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Abstract
From 1980-1982, 100 consecutive cadaver renal transplants were performed. All but 2 recipients received preoperative transfusion and all received an initial 2 wk course of antilymphoblast globulin. A prospective controlled evaluation of high vs. low maintenance prednisone, and antilymphoblast globulin vs. i.v. methylprednisolone for first rejection therapy was done. Overall 1 year graft and patient survivals were 77 and 96%, respectively. Graft survival was equal in the high and low steroid groups. Antilymphoblast globulin was as effective as intravenous methylprednisolone in reversing 1st rejections. Graft survival was improved with better donor-recipient matched grafts. Excellent results can be obtained in transfused cadaver renal allograft recipients managed with azathioprine, prednisone and antilymphoblast globulin. The regimen of prophylactic antilymphoblast globulin, low maintenance prednisone, and antilymphoblast globulin alone for first rejections is immunologically effective and steroid sparing.