Steroid-free treatment of renal transplant patients with cyclosporin A: A European multicentre study

In a multicentre trial conducted in eight European centres, 232 recipients of cadaveric renal allografts were randomly allocated to receive either cyclosporin A (CyA, 117 patients) or azathioprine and steroids (control, 115 patients) for immunosuppression. After a follow-up period of up to eleven months, graft survival probability estimates are 73% in the CyA group and 53% in the control group. Two deaths have occurred In the CyA group and seven in the control group. 82% of the CyA group with functioning grafts are receiving CyA alone, 17% have been changed to azathioprine and steroids and one patient is receiving prednisolone in addition to CyA; 27% have never received steroids. At six months post-transplant renal function is similar in patients receiving CyA and in those receiving azathioprine and steroids. On the basis of these preliminary results CyA appears to be more effective than conventional immunosuppression and avoids the necessity of long-term steroid therapy.