Preliminary experience with cyclosporin A in human renal allografts

We would conclude that in human renal transplantation CY-A has not achieved the unique immunosuppressive activity as shown in some animal experiments. When used alone in two patients, both had apparently unmodified severe histologic evidence of rejection. Used in combination with azathioprine and prednisolone. CY-A does not appear to enhance graft survival. This combination of agents is associated with an unacceptably high rate of infection with viral and fungal organisms. It may be that CY-A will have a role to play in transplantation but not combined with other agents, such as Calne has suggested, or modifications of the parent compound may be safer and more effective. In light of this preliminary experience we are now using CY-A alone and treating rejection crises with short pulse doses of steroid therapy.