Deoxyspergualin. Mode of action and clinical trials.

Corticosteroids are commonly used in combination with cyclosporine in clinical kidney recipients, and administered indefinitely to many patients. Long-term administration of steroids is associated with a number of serious side effects including hypertension, obesity, hyperlipidemia, diabetes mellitus, cataract, osteoporosis, infection, moon face, and so on. A disturbance of growth is also a serious problem in pediatric patients. It is therefore desirable to discontinue the administration of steroid in renal allograft patients. For the withdrawal of steroid, it is quite important to thoroughly inhibit the recipient immune responses during the induction phase of immunosuppression without any serious adverse effect, that the patient may not retain immunological memories against donor antigens for a long period. Thus, we have been performing extensive immunosuppressive therapy using quadruple drugs, that is, DSG, cyclosporine, mizoribine, and prednisolone, during the early stage after kidney transplantation for withdrawal of prednisolone during the maintenance stage. Up to now, 19 recipients were treated with this protocol. In these patients, 8 were completely discontinued on the steroid and have been maintaining excellent graft function 9.2 to 32 months after transplantation, and 2 were reduced on the steroid to 5 mg. The present protocol may contribute greatly toward the quality of life in renal recipients.