Quadruple immunosuppression in 305 consecutive cadaver renal allografts

Three hundred five consecutive patients receiving cadaver renal allografts using quadruple immunosuppressive therapy are reported. Quadruple immunosuppression consisted of prednisone, imuran, antilymphocyte globulin, and cyclosporine. Prednisone, azathioprine, and antilymphocyte globulin were administered immediately postoperatively, and cyclosporine was started when the serum creatinine had fallen to 3.0 mg/dl. Maintenance immunosuppression consisted of imuran, cyclosporine, and low‐dose prednisone. Graft survival in the primary transplant group was 87% at 1 yr and 85% at 2 yr. Graft survival in the retransplant group was 58% at 1 and 2 yr. Only 5 patient deaths were due to infectious complications, indicating that quadruple immunosuppression does not increase the risk for life‐threatening sepsis. We conclude that quadruple immunosuppressive therapy is effective in patients receiving primary cadaver allografts.