Renal transplantation, past, present and future.

In the absence of immunosuppression, renal transplantation was sporadically and unsuccessfully performed during the first half of this century. Over the past 40 years, immunosuppressive drug regimens have evolved greatly and transformed solid-organ transplantation into a routine clinical procedure with a 1-year graft survival between 80% and 90%. The original immunosuppressive scheme was based on the administration of glucocorticoids and azathioprine.

Pediatric renal transplantation from the early 1970's through the cyclosporine years at Policlinico University Hospital of Milan.

In our 27 years' experience, 268 kidney transplantations have been carried out in 243 patients, who were under age 18 at the time of operation. Most (84.7%) received a cadaver donor graft.

The clinical status of cadaveric renal transplant patients treated for 10 year with cyclosporine therapy.

In this paper we assessed the clinical status of 150 cadaveric renal transplant patients who received cyclosporine without interruption for 10 yr. The mean creatinine clearance was 59.2 +/- 15.

Lessons from 494 permanent accesses in 348 haemodialysis patients older than 65 years of age: 29 years of experience.

Currently, patients older than 65 years of age constitute more than 42% of all new enrolments for dialytic treatment in the USA and Italy. Most of these patients are treated by in-centre haemodialysis (HD), with problems connected to vascular access. Personal experience of 494 new vascular accesses in 348 'difficult' HD-patients older than 65 years over 29 years showed the best results from 221 elbow fistulas in comparison with 32 forearm fistulas (78% vs 57.

Randomized study with cyclosporine in kidney transplantation: 10-year follow-up.

This study presents the 10-yr follow-up results of a multicenter controlled trial on 108 recipients of cadaveric renal transplantation, randomized to receive cyclosporine (N = 55) or azathioprine (N = 53), both in combination with steroids. The 10-yr patient survival rate was 89% in the cyclosporine group and 83% in the azathioprine group (P = not significant [NS]); the 10-yr graft survival was 56% and 35%, respectively (log-rank test, P = 0.009).

Twenty-five years of transplant experience at Policlinico University Hospital of Milan.

1. CsA treatment played a major role in the improvement of renal transplantation in the third era of our experience for every class of recipient. Many of the most recent patients involved higher risks than in previous eras.

Advantages of cyclosporine as sole immunosuppressive agent in children with transplanted kidneys.

A prospective study of intentional stopping of steroids 6 months after transplantation was done with 29 pediatric renal transplant recipients with a mean age of 10.4 +/- 3.4 years.

Pregnancy in kidney recipients under cyclosporine.

About 1 of every 50 women of child-bearing age who have a functioning kidney transplant become pregnant. Successful pregnancies following kidney allotransplantation with conventional immunosuppressive treatment are well described, and there is no evidence of abnormalities in the infants born. The use of cyclosporine (CSA) means new problems for the pregnant women and the fetus: the risk of congenital abnormalities, fetal growth retardation, hepato- and nephrotoxicity.

A randomized prospective trial comparing cyclosporine monotherapy with triple-drug therapy in renal transplantation.

In a prospective trial 151 recipients of renal transplants were randomly assigned to treatment with CsA alone (74 patients) and to low dose of AZA, prednisolone, and CsA (77 patients). At two years, graft survival was 84% for the monotherapy and 90% for the triple therapy. This difference was not statistically significant.

Maintained cellular function of adrenal medullary cells in parkinsonian dysautonomia.

Adrenal gland involvement in Parkinson's disease was reported by different authors. Further studies became relevant after adrenal was proposed as dopaminergic donor for neurotransplantation. Chromaffin cells were grown in culture and the effects of nerve growth factor (NGF) tested: no differences were observed between parkinsonian and control cells.

Prolactin, thymulin and zinc in chronic hemodialysis: effect of renal transplant.

The interrelationships between PRL, thymulin and Zn, were studied in 25 patients with chronic renal failure (CRF) undergoing kidney transplantation and immunosuppressed with cyclosporine A (CsA). The possible role of serum PRL levels in predicting allograft rejection was also investigated. Before the kidney transplant serum PRL levels were significantly higher than in normals (mean +/- SE, 28.