Cyclosporine in renal transplantation: a single institutional experience.

Cyclosporine (CsA) as immunosuppression in renal transplantation was evaluated in a single institutional experience to answer several controversial questions. CsA was found to be the superior method of immunosuppression for primary cadaveric renal transplantation. Graft survival, with CsA, was improved over that with conventional immunosuppression which included an antilymphocyte preparation. CsA was found to be the immunosuppressive agent of choice in retransplantation for patients who had rejected a previous renal allograft. Also, CsA was indeed the agent of choice for immunosuppression in patients over 50 years of age seeking renal transplantation. The risks of CsA following transplantation were almost exclusively related to the associated nephrotoxicity. The nephrotoxicity, however, was easily manageable through a defined management strategy which titrates the CsA dose to renal function. CsA was also found to be more cost effective when compared to conventional immunosuppression. Morbidity was substantially decreased with CsA as fewer infectious complications and rejection episodes resulted.