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Biomedical subjects

P Rieu

Publications and source records attributed to P Rieu.

45 records · Page 3Linked to original sources

[Results, over a 3-year, period of a triple combination: cyclosporin, azathioprine, prednisolone in high-risk kidney transplants].

A prospective study was conducted on 57 high-risk patients having received cadaver renal transplants between January 1983 and May 1984, and submitted to the triple combination: cyclosporine, azathioprine, and steroids. 23 patients of Group I including 12 pre-sensitized and poorly matched recipients were treated from the Day 1 post-transplant. 34 patients of Group II received the triple combination following a steroid-ALG resistant rejection. Actuarial graft survival in the whole group was 74%, 64%, and 64% at 1, 2, and 3 years respectively. Patient survival was 100% in the Group I, vs 85% at 1 year, and 82% at 2 years in the group II (p less than 0.02). The incidence of infectious complications and infectious deaths was significantly higher in patients of Group II. Our results suggest the effectiveness of a triple low-doses combination in high-risk renal transplantation, but the delayed use of this combination following a treatment with high-doses of steroids and ALG fails to reverse the rejection, with an obvious overimmunosuppression risk.

Adolescent↗

[Prospective study of a triple immunosuppressive combination in renal transplantation: cyclosporin A-corticoids-azathioprine].

Cyclosporin A significantly improves patient and graft survival as compared with the conventional corticosteroid-azathioprine treatment. However, the results are the same, or even worse, when the cyclosporin A-corticosteroid regimen is compared with the corticosteroid-azathioprine-antilymphocyte globulin regimen. The authors have investigated a prednisone-azathioprine-low dose cyclosporin A combination in 46 high risk patients from a series of 117 renal transplantations performed in 1983. The actuarial patient and graft survival rates were as good as, but not better than, those obtained in 1982 in 106 patients treated with the conventional regimen which includes antilymphocyte globulin; they were 96.5% vs 98% and 85.5% vs 84% respectively at 6 months; 96.5% vs 98% and 83.5% vs 84% respectively at 12 months. The low dosage utilized (8 mg/kg instead of the usual 14-17 mg/kg) avoided virtually all the extrarenal side-effects of cyclosporin A, but not its nephrotoxicity. The theoretical risk of excessive immunosuppression was not confirmed by our study. Since cyclosporin A is very expensive, other therapeutic methods for optimal usage of that drug should be investigated.

Azathioprine↗

[Renal transplantation and pregnancy].

The authors report four cases of pregnancy in a series of 174 women who had undergone renal transplantation. In one case the pregnancy was complicated by a pre-eclamptic attack and premature delivery. A review of the literature shows that the risks to the mother and the kidney are marginal. The risk to the child, however, is more serious. Pregnancy in transplant patients is therefore a high-risk pregnancy requiring advance precautions and careful surveillance.

Adult↗