Alternative antirejection treatment with steroids or antilymphoblast globulin in renal transplant patients receiving cyclosporine.

: An alternative antirejection protocol using corticosteroids or ALG for reversal of initial acute rejections was studied during a 2-year period in 112 mismatched renal transplant recipients receiving CsA. The majority of patients were cadaver transplant recipients. Thirty-five initial episodes of acute rejection occurred; twelve patients with early or histologically severe rejection were treated with ALG and 23 patients with late, nonsevere rejection received corticosteroid therapy. The overall success rate was approximately 90%, with 21 of 23 corticosteroid-treated patients and ten of 12 ALG-treated patients responding to therapy. The two treatment modalities did not differ with respect to subsequent hospital admissions for fever, second rejections, graft survival, or patient survival. Corticosteroid-treated patients realized significant cost savings and required a shorter hospital stay when compared to ALG-treated patients. An alternative antirejection treatment protocol may be highly effective, safe, and cost beneficial.