CYCLOSPORINE VERSUS AZATHIOPRINE - A 5-YEAR FOLLOW-UP OF 200 CONSECUTIVE CADAVER RENAL-TRANSPLANT RECIPIENTS

When cyclosporine was introduced as an immunosuppressive agent, there was concern that cyclosporine could be detrimental to long-term renal allograft function and survival. In response to this concern, we repor t a 5-year followup of 200 consecutive renal transplant recipients amo ng whom initial immunosuppression and risk factors were similar except for the substitution of cyclosporine for azathioprine in the second 1 00 recipients. The azathioprine and cyclosporine groups had similar 1- year (89% versus 91%) and 5-year (74% versus 80%) patient survival rat es. Cyclosporine treated patients had superior 1-year (83% versus 58%) and 5-year (61% versus 29%) graft survival rates. At the g-year inter val, cyclosporine treated grafts had an elevated, yet stable, mean ser um creatinine level compared to azathioprine treated grafts. Despite o ngoing mild renal dysfunction in cyclosporine treated grafts, cyclospo rine does not induce an inexorable decrease in graft function and cont inues to provide long-term graft survival superior to azathioprine.