骁悉和环孢素-A预防肾移植术后早期急性排斥反应

目的 探讨骁悉和环孢素－Ａ预防肾移植术后早期急性排斥反应的效果。方法 回顾性分析１９９７年１２月￣１９９９年１月临床资料完整肾移植患者１４６例,随访时间６￣１６个月。根据应用免疫抑制剂方案的不同分为硫唑嘌呤（Ａｚａ）组（环孢素－Ａ、泼尼松龙、Ａｚａ）和骁悉（ＭＭＦ）组（环孢素－Ａ、泼尼松、ＭＭＦ）。其中Ａｚａ组７８例,ＭＭＦ组６８例。所有受者术前行人类白细胞抗原（ＨＬＡ）配型,ＨＬＡ错配≤３个位点     

移植肾局灶性梗死一例

患者，男，６０岁，因“慢性肾功能不全尿毒症期、慢性肾小球肾炎”，于１９９６年５月在我院行同种异体肾移植术，术后长期应用环孢素Ａ，泼尼松和硫唑嘌呤三联免疫抑制剂抗排斥治疗。１９９７年１月出现发热，肾功能异常，移植肾约１０．０ｃｍ×５．０ｃｍ大小，中等硬...     

同种原位心脏移植的免疫抑制治疗

对２例同种原位以及移植受者采用环孢素Ａ（ＣｓＡ）、硫唑嘌呤（Ａｚａ）及皮质类固醇三联疗法进行免疫抑制治疗，治疗分为围手术期及长期维持两个阶段。围手术期的免疫抑制剂用量较大，１周后逐渐减量，ＣｓＡ１２个月后达维持量（２－３ｍｇ，ｋｇ＾－１／ｄ），Ａｚａ术后４０周达维持量（１．２－１．５ｍｇ．ｋｇ＾－１／ｄ），皮质粝固醇１年后停用。例１、例２分别发生３次，１急性排斥反应，经冲击治疗逆转。２例患者用药后     

肾移植术后环孢素向硫唑嘌呤转换的临床研究

目的 观察肾移植木后环孢素向硫唑嘌呤转换的临床效果。方法 选择60例术后1年以上、肾功能稳定的肾移植受者进行免疫抑制剂从环孢素向唷唑嘌呤的转换。结果 60例病人平均血清肌酐在转换后1个月明显下降(148±58.5至132±86.9mmol/L,P<0.01),并在以后几年内继续下降,转换后6年时平均血清肌酐为112±39.8mmol/L。转换后平均血压也明显下降,并且抗高血压药物数量逐渐减少(P<0.01)。分别有9例(15％)和3例(6.7％)病人在转换后3个月内和3个月后发生急性排斥反应。转换后1年、5年人/肾存活率分别为95％/81.7％、86.7％/78.3％。5例(8.7％)病人因药物副作用和慢性排斥反应从硫唑嘌呤再转换为环孢素。结论 肾移植受者在术后一定时间将免疫抑制剂从环孢素转换为硫唑嘌呤是一种安全的免疫抑制方案,具有较好的移植肾长期存活。     

骁悉与小剂量环孢素A在尸体肾移植中的联合应用

为观察骁悉（ＭＭＦ）与小剂量环孢素Ａ（ＣｓＡ）联合应用于尸体肾移植中的效果，将１６例患者随机分为３组，ＭＭＦ２．０ｇ组（ＭＭＦ用量为２．０ｇ／ｄ）；ＭＭＦ１．５ｇ组（ＭＭＦ用量为１．５ｇ／ｄ）；硫唑嘌呤（Ａｚａ）组。３组患者均同时接受相似剂量的ＣｓＡ和类固醇治疗。结果ＭＭＦ２．０ｇ组未发生急性排斥；ＭＭＦ１．５ｇ组１例（１／５）患者先后发生２次排斥；Ａｚａ组３例（３／５）患者各发生１次排斥。术后６个月ＭＭＦ２．０ｇ组患者血清肌酐值明显低于Ａｚａ组，其所用的ＣｓＡ剂量低于Ａｚａ组。认为ＭＭＦ无明显肝、肾毒性，每天２．０ｇ口服，并与小剂量ＣｓＡ和类固醇联合应用，临床疗效明显优于传统的三联疗法。     

骨髓输注和抗淋巴细胞球蛋白诱导对同种异体移植肾特异性免疫无反应性的临床研究

国外使用抗淋巴细胞球蛋白（ＡＬＧ）和输入供体特有骨髓（ＢＭ）诱导同种移植物的耐受力，并建立了动物模型。我们将这研究用于诱导特异性免疫无反应性病例２０例（骨髓组），并随机抽样２２例尸体肾移植患者作为对照组。骨髓组接受常规三联免疫抑制治疗，在１４天从ＡＬＧ诱导期后，停用１周，于第７天输入冷藏骨髓，随访５～４１个月。结果：１～６个月发生排斥反应２例（２／２０），均用大剂量激素逆转；另１例合并败血性肺炎死亡。对照组采用三联常规免疫抑制治疗剂量较骨髓组大，但不输入骨髓，结果同期发生排斥反应６例（６／２２），后期排斥反应２例，其中４例因排斥反应未能逆转而移植肾失功，有１例因合并心衰死亡。从两组结果分析，人的一年成活率两组无明显差别。移植肾一年成活率则骨髓组高于对照组（Ｐ＜０．０１），排斥反应发生率骨髓组明显低于对照组（Ｐ＜０．０５），且骨髓组常规免疫抑制剂用量较对照组小。     

肾移植患者停用环孢素A后近期急性排斥及安全停用环孢素A临…

对５０例肾移植患者停用环孢素Ａ的全过程进行了分析。发现停药后６－６０天共发生急性排斥１６例次，排斥率３０．８％。术后用药不足６个月者排斥率８０％，而用药６个月－１年和１年以上者分别为２２．２％，３６．３％，前者排斥率明显高于后两者，而后两者之间无差异。     

用于肾移植的几种免疫抑制方案的对比研究

目的 比较肾移植后几种常用免疫抑制治疗方案的疗效与副作用。方法 根据所使用的免疫抑制治疗方案将８７例肾移植患者分为４组,Ａ组的免疫抑制治疗方案为他克莫司（ＦＫ５０６）、霉酚酸酯（ＭＭＦ）和泼尼松（Ｐｒｅｄ）;Ｂ线为环孢素Ａ（ＣｓＡ）、ＭＭＦ和Ｐｒｅｄ;Ｃ组为ＣｓＡ、硫唑嘌呤（Ａｚａ）和Ｐｒｅｄ;Ｄ组为ＣｓＡ和Ｐｒｅｄ。观察术后移植肾功能的恢复情况、排斥反应发生率、并发症及免疫抑制剂用量的变化。结果     

肾移植术后并发肺部与脑膜隐球菌病一例

患者，女性，４６岁。因慢性肾盂肾炎、尿毒症，于１９９４年２月行异体肾移植术，术后３天移植肾功能恢复正常，１个月出院。继续口服免疫抑制剂环孢素Ａ、硫唑嘌呤、泼尼松等治疗。１９９７年１月反复咳嗽、发热伴头痛１个月，少量咳痰但无痰中带血，体温达３８．５℃。...     

肝移植术后免疫抑制剂的个体化治疗

目的 总结肝移植术后免疫抑制剂个体化治疗经验.方法 回顾性分析32例肝移植患者免疫抑制剂使用与排斥反应防治情况,除外术后早期3例因非排斥反应原因死亡,共随访观察29例患者不同时期采用不同的免疫抑制方法的效果.结果 1例术后1年半自行停药,6个月后因免疫因素相关的慢性排斥死亡.术后1个月内轻微急性排斥反应3例,1例1个月后急性排斥反应,所有排斥反应均因药物浓度低或长时间停药造成,均早期发现,经加用FK506及激素后控制,现存活的11例中,CsA最低用量为2 mg/(kg·d),FK506最低用量为0.02 mg/(kg·d).结论 应根据受体免疫状态、术后不同时期、合并的特殊病情及对免疫抑制剂的个体差异等来决定免疫抑制剂方案及用量.     

Amelioration of chronic renal allograft dysfunction in cyclosporine-treated patients by addition of azathioprine

Management of chronic renal allograft dysfunction in cyclosporine-prednisone treated renal allograft recipients remains problematic. We therefore initiated a protocol of azathioprine addition (1.0-1.5 mg/kg/day) to ongoing CsA/Pred therapy. Three groups were treated. Group A (n = 21) had chronic progressive renal dysfunction (serum creatinine greater than or equal to 2.5 mg/dl or more than 15% above baseline) four or more months after transplantation. Group B (n = 8) had frequent or severe rejection episodes occurring despite adequate CsA levels. Group C (n = 7) had constitutional side effects of CsA with or without renal dysfunction persisting despite drug taper or financial difficulty in affording CsA. Aza was initiated 17.8 +/- 2.8 months after transplantation in group A, the mean serum creatinine having risen from 2.55 +/- 27 mg/dl to 3.04 +/- .20 mg/dl (P = .07) over the six months preceding Aza initiation, despite stable and low therapeutic range HPLC whole-blood CsA levels (118 +/- 10 ng/ml vs. 133 +/- 11 ng/ml, P = NS). Renal function declined at a rate of -0.20 +/- .06 Cr1/year in the six-month period before addition of Aza, and then improved at a rate of 0.09 +/- .04 Cr-1/year after addition of Aza (P = .002). These changes in renal function occurred without a decrease in CsA levels (118 +/- 10 six months before Aza vs. 126 +/- 26 six months after Aza, P = NS). In group B Aza was initiated at 58 +/- 8 days after transplantation when mean sCr was 3.56 +/- .29 mg/dl and mean CsA level was 222 +/- 17 ng/ml. At least follow-up 12.7 +/- 2.0 months after addition of Aza, all group B grafts were functioning, mean sCr was 2.69 +/- .31 mg/dl (P = .09 compared with baseline), and mean CsA level was 128 +/- 34 ng/ml (P = .07 compared with baseline). Group C patients had addition of Aza at 43 +/- 19 months after transplantation when mean sCr was 2.97 +/- .60 and mean CsA level was 125 +/- 30 ng/ml; addition of Aza had no influence on the rate of decline in renal function in this group. Of these 36 patients, 6 received therapy for acute rejection over the entire follow-up period of 12.3 +/- 1.4 months after addition of Aza; 4 of these retain graft function. Infectious complications consisted of 2 urinary tract infections, 1 bacterial pneumonia, and one case of otitis media.(ABSTRACT TRUNCATED AT 400 WORDS)     

Long-term beneficial effects of azathioprine addition to ongoing cyclosporine-prednisone protocol in renal transplantation

Delayed addition of azathioprine (Aza) to an ongoing cyclosporine-prednisone protocol was started 11.3 ± 9.9 months after renal transplantation in 31 patients. Group I (n = 10) had chronic renal function deterioration due to chronic rejection, group II (n = 11) had repeated or severe acute rejection episodes and group III (n = 10) had cyclosporine (Cs) toxicity despite drug tapering. In group I, SCr had risen over the 6 months prior to Aza addition (P < 0.05), renal function declining at a rate of ?0.13 ± 0.12 SCr^?1. In the 6 months post-Aza, renal function improved at a rate of 0.05 ± 0.07 SCr^?1, and during the entire follow-up at a rate of 0.05 ± 0.12 SCr^?1 (P < 0.01) with stable Cs levels. In group II the decline in renal function was greater, though the rate of decline was stopped after Aza. In group III, renal function improved in eight patients. After 23 ± 12 months of follow-up, 15 patients had improved graft function, two were stable, 12 had worsened (nine on dialysis) and two had died. Amelioration of chronic graft dysfunction can be achieved by delayed addition of Aza to Cs-prednisone-treated renal allograft patients with chronic rejection or Cs toxicity, with long-term beneficial effects in a high proportion of patients.     

Evidence that addition of azathioprine improves renal function in cyclosporine-treated patients with allograft dysfunction

Several approaches have been attempted to manage renal allograft dysfunction in cyclosporine-prednisone (CsA-Pred)-treated patients. Conversion to conventional therapy and perioperative triple drug have been associated with high rates of acute rejection episodes, infections, or neoplasms. We report our experience in delayed addition of azathioprine (1-2 mg/kg/day) to CsA/Pred protocol in three groups of patients. Group I (n = 9) had chronic renal function deterioration due to chronic rejection; group II (n = 10) had repeated or severe acute rejection episodes despite adequate CsA levels; and group III (n = 8) had CsA toxicity despite drug tapering. In group I, serum creatinine (SCr) had risen from 2.2 +/- 0.9 to 2.9 +/- 0.7 mg/dl over the 6 months prior to Aza addition (P less than 0.05), renal function declining at a rate of -0.14 +/- 0.12 Cr-1/year. In the 6-month post-Aza, renal function improved at a rate of 0.06 +/- 0.06 Cr-1/year and during the entire follow-up at a rate of 0.04 +/- 0.12 Cr-1/year (P less than 0.05) with stable CsA levels (288 +/- 167 vs. 251 +/- 172 ng/dl, NS). In group II response was worse, though the rate of declining renal function prior to Aza (-0.10 +/- 0.10 Cr-1/year) was almost stopped after Aza. In group III there was very good response to Aza addition, as 7 out of 8 patients improved graft function (baseline SCr 2.5 +/- 0.7 mg/dl vs. 1.9 +/- 0.6 mg/dl at last follow-up, P less than 0.05), with significantly decreased CsA levels (480 +/- 97 vs. 268 +/- 120, P less than 0.05). One patient from group II died from pneumonia, and 6 patients (1 from group I and 5 from group II) lost their grafts. Fifteen patients improved graft function, and 9 worsened after addition of Aza. The bad-responders had significantly higher SCr at baseline compared with the good-responders (3.8 +/- 1.8 vs. 2.7 +/- 0.6 mg/dl, P less than 0.01). Amelioration of chronic graft dysfunction can be achieved by delayed addition of Aza to CsA-Pred in patients with chronic rejection or CsA toxicity. This is accompanied by low rate of acute rejection, good patient and graft survival, and low rate of infections. A worse outcome can be seen in patients with high-baseline SCr levels, suggesting the need for addition of Aza in the initial chronic graft dysfunction.     

Mycophenolate mofetil does not modify the incidence of cytomegalovirus (CMV) disease after kidney transplantation but prevents CMV-induced chronic graft dysfunction.

Ganciclovir, which is used to treat cytomegalovirus (CMV) infection, has been shown in rodent models to abolish CMV-mediated chronic cellular damage and endothelial cell proliferation; when associated with mycophenolate mofetil (MMF), it has been shown to increase its anti-herpes virus activity. This study tested the hypothesis that kidney graft recipients who received antirejection prophylaxis with MMF and who were treated with ganciclovir for a declared CMV disease could be protected from chronic graft dysfunction. Investigated was the impact of ganciclovir-treated CMV diseases in consecutive first kidney recipients according to their immunosuppressive therapy. The azathioprine (Aza)-treated group (Aza group) included 319 patients. The MMF-treated group (MMF group) included 126 patients. CMV disease was clinically defined and confirmed by virological proof of CMV infection and was treated for at least 14 d with ganciclovir. Despite having the same incidence (21.6% in the Aza group versus 24.6% in the MMF group) and severity, CMV disease was significantly associated with graft loss independent of acute rejection episodes or other factors when tested in a Cox proportional model in the Aza group only (P < 10(-4)). It was shown for the first time that patients whose CMV disease is treated with ganciclovir while they are on MMF therapy are protected from the long-term deleterious consequences of CMV disease on graft survival, independent of acute rejection. It is suggested that the enhanced anti-herpes virus activity of ganciclovir by MMF could contribute to this reported effect, which may represent a significant contribution of MMF efficacy to graft survival.     

慢性排斥治疗的经验与体会

为探讨慢性排斥的治疗方法对５９例肾移植术后发生慢性排斥反应患者的治疗情况进行总结。治疗包括调整原免疫抑制方案，加用甲泼尼龙，环磷酰胺，单克隆及多克隆抗体，雷公藤，百令胶囊，尿毒清等，结果１１例的肾功能得以恢复或稳定。     

Conversion from mycophenolate mofetil to azathioprine in renal allograft [corrected] patients within the first month posttransplantation

This retrospective study evaluated the safety of conversion from mycophenolate mofetil (MMF) to azathioprine (Aza) within the first month posttransplantation in 117 renal allograft patients concomittantly treated with cyclosporine (CsA) and prednisone. In 52 Conversion from MMF to Aza was conducted at 2 to 4 weeks posttransplantation in 52 patients (conversion group). Thirty-six patients received MMF (MMF group) and 29 patients were treated with Aza (Aza group). Patients were monitored for allograft function, acute rejection episodes, and CsA levels. The demographics were comparable between groups with respect to age, as well as warm and cold ischemic times of allografts. The cumulative allograft survival rates at 1, 2, 3, and 5 years were 98% +/- 2%, 96% +/- 3%, 90% +/- 4%, 90% +/- 4% in the conversion (n = 52) group versus 79% +/- 7%, 79% +/- 7%, 79% +/- 7%, and 75% +/- 8% in the MMF group (n = 36) versus 93% +/- 5%, 93% +/- 5%, 82% +/- 7%, and 78% +/- 8% in the Aza group (n = 29). The CsA trough levels at 1 year posttransplantation were 208.39 +/- 93.79 ng/mL in the conversion group; 159.30 +/- 52.99 ng/mL in the MMF group; and 241.82 +/- 112.76 ng/mL in the Aza group. The acute rejection rates during a 5-year follow-up were 28.85% in the conversion group; 27.78% in the MMF group; and 24.14% in the Aza group. The rejection-free allograft survival between the conversion group and the MMF group was identical (P < .921). However, allograft survival in the conversion group with acute rejection was significantly higher than the MMF group (P < .024). In conclusion, early conversion from MMF to Aza among renal allograft patients was safe without increased acute allograft rejection during a 5-year follow-up. The overall allograft survival in the conversion group was comparable to patients treated with MMF or Aza therapies.     

Optimization of the immunosuppressive protocol after lung transplantation.

BACKGROUND: The successful use of tacrolimus (Tac)-based immunosuppressive therapy in organ transplantation and our own positive experience in heart transplantation led us to investigate regimens including this agent at our center for lung transplantation. METHODS: From 1991 to 1998, 86 patients underwent lung transplants at our center and 78 of them were included in this analysis. The first 34 patients were treated with cyclosporin (CsA), azathioprine (Aza), and rabbit antilymphocyte globulin; the subsequent 30 patients received Tac with Aza, and the most recent 12 patients Tac with mycophenolate mofetil (MMF). In addition, all patients received prednisone. RESULTS: The number of acute rejection episodes per 100 patient days was 1.5, 0.6, and 0.3 for three treatment groups, respectively. Similarly, the incidence of refractory acute rejection per 100 patient days was lower in both Tac groups (0.20, 0.03, and 0, respectively). Freedom from acute rejection was highest in the Tac-MMF group (P=0.0037 vs. Tac/Aza, P=0.0007 vs. CsA/Aza). Freedom from recurrent acute rejection was significantly higher in both Tac groups (P=0.027 Tac/ Aza vs. CsA/Aza and P=0.025 Tac/MMF vs. CsA/Aza). The incidence of infections per 100 patient days was similar (0.8, 0.5, and 0.8) in all three treatment groups, with a similar distribution of fungal, bacterial, and viral infections. Freedom from infection also showed no difference. The survival rate was significantly higher for the Tac population, with actuarial 1- and 3-year survival rates of 93% and 71%, compared with the CsA group (71% and 51%, respectively, P=0.04). Prevalence of renal dysfunction (creatinine >2.0 mg/ dL) was 18%, 13%, and 0% in the 3 treatment groups, respectively. The development of glucose metabolism disorders was lower in the CsA group than in the Tac-Aza group (15% vs. 27%, P<0.05). CONCLUSIONS: Tac-based immunosuppressive therapy results in a lower rate of acute rejection after pulmonary transplantation, with similar infection rates and a slightly higher incidence of new onset diabetes mellitus compared with CsA-based therapy.     

Renal allograft immunosuppression: VI. Triple drug therapy versus immunosuppressive double drug combinations: histopathological findings in renal allografts

Abstract. The long-term effects of different immunosuppressive drugs and regimens on renal allograft histology are virtually unknown. Therefore, in order to investigate the long-term effects of triple drug treatment versus different combinations of two immunosuppressive drugs on allograft histology, a prospective, randomized trial was performed. One group received triple therapy consisting of low-dose cyclosporin (CyA), azathioprine (Aza), and methylprednisolone (MP), and three groups received combinations of two drugs, i.e., Aza plus CyA, Aza plus MP, and CyA plus MP. At 2 years, there were no significant differences with regard to graft (80%) or patient (87%) survival, or to graft function between the four groups. After 2 years, a protocol core biopsy was taken of all 102 patients having a functioning graft. Of these patients, 61 (60%) were still following the original, randomized treatment protocol; in the remaining cases, changes had occurred in the original protocol and so these cases were considered drop-outs in this study. Histological specimens were examined blindly by two independent observers. Most of the 34 histological variables examined showed no changes. Diffuse fibrosis was most frequent in the CyA plus MP group (70%) and significantly more severe than in the triple therapy group. Mesangial matrix increase in glomeruli was significantly less common in the triple therapy group (8%) than in any one of the double drug combination groups (47%). Two other changes in glomeruli - Bowman capsular thickening and global glomerular sclerosis - were also less frequent in the triple therapy group. Vascular changes other than intimal proliferation (39%) and arteriosclerosis (24%) were uncommon in all groups and least frequent in the triple therapy group. Isometric vacuolation in proximal tubules was found in every group using CyA. It was least prominent in the triple therapy group and most prominent in the CyA plus MP group; it was not seen in the Aza plus MP group. Other specific findings for the groups treated with CyA could not be identified. To summarize, the changes shown were mild and rather similarly distributed in the four treatment groups. Histopathological alterations comparable with chronic rejection, i.e., persistent interstitial inflammation with pyroninophilic cells, vascular intimal proliferation, and arteriosclerosis, were seen in all groups, but these changes were least prominent in the group receiving triple therapy.     

冬虫夏草制剂在肾移植术后早中期的应用研究

目的 :为研究冬虫夏草制剂 (百令胶囊 )的活性成份在肾移植术后早、中期的免疫抑制作用。方法 :将肾移植患者分为 3组 :A组为百令胶囊 Pred CsA ;B组为百令胶囊 Pred CsA Aza ;C组为Pred CsA Aza ,进行分组对照观察。结果 :(1)急性排斥发生情况 :A组 16 .5 % (33/ 2 0 0 ) ,B组 11.79% (33/ 2 80 ) ,C组 16 % (16 / 10 0 ) ;(2 )肝功能损害情况 :A组 18.5 % ,B组 2 1.0 7% ,C组 2 5 % ;(3)白细胞下降 :A组无 ,B组 12例 ,C组 8例 ;(4)慢性排斥 (CR)的治疗情况 :A、B组之CR在使用百令胶囊后 ,尿中 2 4h蛋白排出量较C组减少或显著减少 ,血清肌酐明显回落。结论 :从研究可见 ,百令胶囊具有良好的预防急性排斥作用 ,保护肝细胞免受药物、肝炎病毒的损害作用 ,对CR具有一定的治疗作用 ,能提高移植物的长期存活率     

Cyclosporine toxicity: the effect of combined therapy using cyclosporine, azathioprine, and prednisone

Forty-nine patients among 360 who received renal transplants under cyclosporine (CsA)/prednisone (Pred) immunosuppression required alteration of the immunosuppressive regimen because of intractable nephrotoxicity. Twenty-five patients, converted totally to azathioprine (Aza)/Pred, suffered intractable nephrotoxicity with no associated evidence suggesting ongoing rejection. The results with Aza/Pred conversion were disappointing because of an unacceptably high incidence of rejection and allograft loss. Twenty-four patients with intractable CsA nephrotoxicity were, therefore, treated using an alternative approach combining Aza with aggressive CsA dose reduction, and continued Pred therapy. All patients tolerated initiation of Aza without complication; allograft rejection was not common. Renal function improved for 23 of the 24 (96%) CsA/Aza/Pred patients with mean serum creatinine levels falling from 3.5 +/- 0.5 mg/dL to 2.2 +/- 0.4 mg/dL after a mean follow-up of 14 months (P less than .001). Among 18 patients observed at least 12 months, seven (39%) enjoyed serum creatinine values less than or equal to 2 mg/dL. Nine CsA/Aza/Pred-treated patients (37.5%) required hospitalization because of infectious complications, all of which resolved with temporary reduction of immunosuppression and specific antimicrobial therapy when indicated. One patient sustained acute allograft rejection as a result of patient noncompliance, and one patient on a seemingly appropriate CsA/Aza/Pred dose responded initially to steroid pulse antirejection therapy; however, renal function again worsened. Two patients developed progressive renal dysfunction due to chronic rejection, and returned to dialysis 13 and 17 months, respectively, following initiation of CsA/Aza/Pred. Overall, the actuarial graft survival for CsA/Aza/Pred-treated patients was 100% at 1 year, and 84% at 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)