Four years' experience with cyclosporin A in pediatric kidney transplantation

• Published in: Acta pædiatrica Scandinavica Vol. 79; no. 6-7; p. 622
• Main Authors: Hoyer, P F, Offner, G, Oemar, B S, Brodehl, J, Ringe, B, Pichlmayr, R
• Format: Journal Article
• Language: English
• Published: Sweden 01-06-1990
• Subjects: Adolescent; Body Height; Body Weight; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Cyclosporins - adverse effects; Cyclosporins - blood; Cyclosporins - pharmacology; Female; Glomerular Filtration Rate - drug effects; Humans; Hypertension - chemically induced; Kidney Transplantation - mortality; Kidney Transplantation - physiology; Male; Regression Analysis; Time Factors
• ISSN: 0001-656X
• DOI: 10.1111/j.1651-2227.1990.tb11526.x

From 1982 to 1987 sixty-three children were treated with cyclosporin A and low dose prednisolone after kidney transplantation. Patient survival rate at 4 years after transplantation was 98.3%, survival rate of living related grafts 100% (n = 10), and survival rate of cadaveric grafts 73% (n = 53). Adequate cyclosporin blood levels were achieved in all children with a dosage regimen related to body surface area. Major concerns during the observation period were the loss of glomerular filtration rate from 51.8 to 40.5 ml/min/1.73 m2, a hypertension rate of 77.8%, and hyperuricemia. Cyclosporin A-side effects were mild. Infections occurred in 11.1%. Growth retardation in prepubertal children improved by 0.74 standard deviations of normal height, and in pubertal children by 0.51. We conclude that cyclosporin A treatment in children enables excellent long term graft survival rates with improved growth rehabilitation, however, the prevention of the cyclosporin associated nephrotoxicity and hypertension remains the major problem.