[Cyclosporin A: experience of the Renal Transplant Unit of the Clinical Hospital of the Medical College of the University of Sao Paulo].

L E Ianhez, P R Chocair, J A Fonseca, L S Azevedo, F J de Paula, E David Neto, J E Romão Júnior, M M Galvão, M C de Castro, S Arap
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Abstract

The authors report their experience using cyclosporine-A (CsA) in renal transplant patients. When compared with azathioprine/prednisone, CsA contributed significantly to a better graft and patient survival, either if used associated with prednisone of with azathioprine plus prednisone. CsA was also used in substitution to azathioprine in patients with hepatopathy attributed to azathioprine toxicity. The initial results are promising. The association of CsA and azathioprine with corticosteroids withdrawal was used as an attempt to allow normal growth in children. This seems to be the best choice of treatment for children. Careful monitoring of CsA blood levels avoids, or at least, minimizes nephrotoxicity. To achieve therapeutic CsA levels, patients with liver damage need lower, while children need higher oral CsA doses. To summarise: when CsA in carefully used, it is an excellent immunosuppressive drug.

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[环孢素A:圣保罗大学医学院临床医院肾移植科的经验]。
作者报告了他们在肾移植患者中使用环孢素- a (CsA)的经验。与硫唑嘌呤/泼尼松相比,无论是与泼尼松联合使用,还是与硫唑嘌呤加泼尼松联合使用,CsA都能显著改善移植物和患者的生存。在硫唑嘌呤毒性肝病患者中,CsA也被用于替代硫唑嘌呤。初步结果是有希望的。CsA和硫唑嘌呤与皮质类固醇停药的关联被用来尝试允许儿童正常生长。这似乎是治疗儿童的最佳选择。仔细监测CsA血药浓度可避免或至少减少肾毒性。为了达到治疗性的CsA水平,肝损伤患者需要更低的口服CsA剂量,而儿童需要更高的口服CsA剂量。综上所述,CsA是一种优良的免疫抑制药物。
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