Treatment of renal transplant rejection episodes in patients receiving prednisone and azathioprine: A cost–effective approach

Arthur J. Matas, Vivian A. Tellis, Theresa Quinn, Gattu Karwa, Daniel Glichlick, Robert Soberman, Frank Veith

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Antilymphocyte globulin (ALG) has been advocated for the treatment of renal transplant rejection episodes in patients maintained on prednisone and azathioprine. Treatment with steroids (outpatient) is considerably less expensive than with ALG (inpatient), so we studied whether routine ALG was necessary. Between 3/82 and 11/83, 54 cadaver transplant recipients maintained on prednisone and azathioprine who developed a first rejection episode were randomized to receive–for treatment of their first, and if necessary second, rejection– methylprednisolone (MP) plus ALG (n = 24), or MP alone, with ALG added if treatment failed (n = 30). Treatment failure was defined as continuing deterioration on <sup>131</sup> iodohippuran scan, rising serum creatinine level, or lack of improvement within 7 days. There was no significant difference in patient survival, graft survival, mean number of rejections, and infection rate between the two groups: 60% (18/30) of first and 50% (10/10) of second rejection episodes responded to MP alone. We conclude that patients are not penalized by initial rejection treatment with MP. Many rejection episodes respond to steroids alone; elimination of routine ALG use will save hospitalization time and expense.

Original languageEnglish (US)
Pages (from-to)35-39
Number of pages5
JournalTransplantation
Volume40
Issue number1
StatePublished - 1985

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Antilymphocyte Serum
Azathioprine
Graft Rejection
Prednisone
Methylprednisolone
Kidney
Therapeutics
Steroids
Graft Survival
Treatment Failure
Cadaver
Inpatients
Creatinine
Hospitalization
Outpatients
Survival
Infection
Serum

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Matas, A. J., Tellis, V. A., Quinn, T., Karwa, G., Glichlick, D., Soberman, R., & Veith, F. (1985). Treatment of renal transplant rejection episodes in patients receiving prednisone and azathioprine: A cost–effective approach. Transplantation, 40(1), 35-39.

Treatment of renal transplant rejection episodes in patients receiving prednisone and azathioprine : A cost–effective approach. / Matas, Arthur J.; Tellis, Vivian A.; Quinn, Theresa; Karwa, Gattu; Glichlick, Daniel; Soberman, Robert; Veith, Frank.

In: Transplantation, Vol. 40, No. 1, 1985, p. 35-39.

Research output: Contribution to journalArticle

Matas, AJ, Tellis, VA, Quinn, T, Karwa, G, Glichlick, D, Soberman, R & Veith, F 1985, 'Treatment of renal transplant rejection episodes in patients receiving prednisone and azathioprine: A cost–effective approach', Transplantation, vol. 40, no. 1, pp. 35-39.
Matas, Arthur J. ; Tellis, Vivian A. ; Quinn, Theresa ; Karwa, Gattu ; Glichlick, Daniel ; Soberman, Robert ; Veith, Frank. / Treatment of renal transplant rejection episodes in patients receiving prednisone and azathioprine : A cost–effective approach. In: Transplantation. 1985 ; Vol. 40, No. 1. pp. 35-39.
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