Journal articles in early June focused on cyclosporine monotherapy in recipients of kidney transplants and on the use of shunts versus paracentesis to avoid liver transplantation.
* Giuseppe Montagnino, MD, and colleagues at Ospedale Maggiore IRCCS in Milan, Italy, found good long-term results with cyclosporine monotherapy in kidney transplant patients. At a median follow-up of 86 months, a third of the 143 patients remained on monotherapy, and the other two-thirds had required the addition of steroid therapy. Cumulative patient and graft survival at 11 years was 89% and 62%, respectively, and cyclosporine monotherapy allowed an estimated graft half-life of 19.9 years. The 11-year graft survival was 53% for patients who received additional therapy. The study was reported in the June issue of the American Journal of Kidney Diseases (2000;35:1135-1143).
* In patients with cirrhosis and refractory or recurrent ascites, the creation of a transjugular intrahepatic portosystemic shunt improved the chance of survival without liver transplantation compared with patients undergoing large-volume paracentesis, Martin RØssle, MD, of Albrecht-Ludwigs-Universität in Freiburg, Germany, and colleagues reported on June 8 in The New England Journal of Medicine (2000;342:1701-1707). During about 45 months of follow-up, there were 15 deaths and 1 liver transplant among 29 patients who received a shunt and 23 deaths and 2 liver transplants among 31 patients undergoing paracentesis. The probability of survival without liver transplantation was 69% at one year and 58% at two years in the shunt group and was 52% and 32% in the paracentesis group, respectively.
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