DEVELOPING THE IDEAL IMMUNOSUPPRESSIVE PROTOCOL BY INTERNAL AUDIT

To identify the best immunosuppressive protocol in a centre where five different regimens are employed, 227 consecutive renal recipients who were transplanted over a 2.5-year period were studied. The five diffe rent regimens employed were cyclosporin monotherapy, dual therapy (cyc losporin and prednisolone), triple therapy (cyclosporin, azathioprine, prednisolone), antithymocyte globulin (ATG) followed by dual therapy and ATG followed by triple therapy. Recipients were chosen for the dif ferent regimens according to HLA mismatch, positive donor crossmatch d ue to IgM, regraft and delayed graft function. The group with the lowe st risk, cyclosporin monotherapy, had the highest acute rejection rate , with only 13 % free of acute rejection (in comparison to triple immu nosuppression, P = 0.024, chi-square test). The overall infection rate and graft success rate were similar between the different groups.