A randomized pilot study of cyclosporin G in renal transplantation
Animal studies have suggested that the analogue cyclosporin G (CyG) may be less nephrotoxic than cyclosporin A (CyA). A pilot study was therefore performed in 10 primary cadaveric renal allograft recipients who were randomized to receive posttransplant immunosuppression with either CyA or CyG. The follow-up time was a minimum of 1 year. One graft was lost in each group. All patients in both groups experienced at least one acute rejection episode. Episodes of acute nephrotoxicity were observed in both groups. Renal function, as assessed by determinations of the serum creatinine level and chromium-ethylene diamine tetra-acetic acid (Cr-EDTA) clearance, did not differ between the two groups. Renal allograft biopsies showed a significantly higher degree of fibrosis in the CyG group than in the CyA group. All CyG-treated patients evidenced laboratory signs of acute liver toxicity, which was dose-dependent and reversible. Today, all CyG-treated patients have been switched to CyA. This study shows that immunosuppression after renal transplantation in man is possible with CyG; however, it does not seem to have any advantages over CyA.
Key wordsImmunosuppression Cyclosporin A Cyclosporin G Renal transplantation
Unable to display preview. Download preview PDF.
- l.Beveridge T, Gugerli U, Huser B, Thiel G (1987) OG 37–325 tolerability/efficacy and first pilot studies in organ transplantation. Sandoz, BaselGoogle Scholar
- 8.Donatsch P, Ruffel D (1986) Effects of cyclosporine A and G on renal function. Experientia 42:668Google Scholar
- 16.Grant Hoyt E, Billingham ME, Maseh MA, Morris RE, Baldwin JC, Jamieson SW (1985) Assessment of cyclosporine G, a new immunosuppressant agent. Heart Transplant 4: 616Google Scholar
- 19.Hiestand PC, Gunn H, Gale J, Siegl H, Ryffel B, Donatsch P, Borel JF (1985) The immunosuppressive profile of a new natural cyclosporine analogue: Nva2-cyclosporine. Transplant Proc 17: 1362–1364Google Scholar
- 21.Lundgren G, Groth C-G, Albrechtsen D, Brynger H, Flatmark A, Frödin L, Gäbel H, Husberg B, Klintmalm G, Maurer W, Persson H, Thorsby E (1986) HLA-matching and pretransplant blood transplantations in cadaveric renal transplantation — a changing picture with cyclosporine. Lancet II: 66–69CrossRefGoogle Scholar
- 29.Shibata N, Minoucki T, Hayashi Y, Ono T, Shimakawa H (1987) Qualitative determination of cyclosporin A in whole blood and plasma by high performance liquid chromatography. Res Commun Chem Path Pharmacol 57:261–271Google Scholar
- 33.Thiru S, Mahler ER, Hamilton DV, Evans DB, Calne RY (1983) Tubular changes in renal transplant recipients on cyclosporine. Transplant Proc 15 [Suppl 1]: 2846–2851Google Scholar
- 38.Wilczek H (1989) Renal allograft biopsy. Core and fine needle biopsy techniques for acute diagnosis and long-term follow-up. Academic thesis, Huddinge Hospital, Karolinska Institute, study III, pp 12–14Google Scholar