Abstract
Prior to the discovery of cyclosporine, azathioprine was the mainstay of immunosuppressant therapy. According to White (1982a), the discovery of azathioprine in 1959 and its subsequent combination with steroids established kidney transplantation as a viable therapy for renal failure. However, although this regimen represented a major step forward, only 50% of the allografts (homografts) achieved with it were functional, and these were accompanied by a 15% mortality rate from secondary infection. Half of the transplanted kidneys were lost within 12 months as a result of rejection (Kahan, 1983; White, 1982b). In only two situations was azathioprine plus corticosteroids consistently effective in renal transplantation: (1) where donors were living, reasonably immune-compatible relatives, or (2) where cadaver organs were given to recipients who tested as weak immune responders. Unfortunately, in the USA, the majority of the young, vigorous population requiring transplants test as strong immune responders (Kahan, 1981).
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Maxwell, R.A., Eckhardt, S.B. (1990). Cyclosporine. In: Drug Discovery. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-4612-0469-5_7
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