Journal Article

The long-acting dopamine agonist bromocriptine mesylate as additive immunosuppressive drug after kidney transplantation.

M Clodi, H Kotzmann, M Riedl, A Schmidt, U Barnas, F Mühlbacher, G Mustafa, W H Hörl, W Waldhäusl, G Mayer and A Luger

in Nephrology Dialysis Transplantation

Volume 12, issue 4, pages 748-752
Published in print April 1997 | ISSN: 0931-0509
Published online April 1997 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/12.4.748
The long-acting dopamine agonist bromocriptine mesylate as additive immunosuppressive drug after kidney transplantation.

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BACKGROUND: Acute rejection is an important risk factor for kidney graft loss. As evidence suggests that prolactin has important immunostimulatory properties, we conducted a randomized, prospective open trial in which bromocriptine, a drug suppressing prolactin secretion, was administered as an additive immunosuppressive drug after first cadaver kidney transplantation. METHODS: In the treatment group bromocriptine was given intramuscularly to 22 patients after their first kidney transplantation along with conventional immunosuppression (cyclosporin A, glucocorticoids). Twenty-three patients receiving only conventional immunosuppression served as control subjects. The incidence of acute graft rejections, graft losses, and infections was evaluated. RESULTS: Serum prolactin concentrations were slightly elevated above normal values before transplantation (32 +/- 5.3 ng/ml) and decreased to values between 13 and 16 ng/ml in the control group and were totally suppressed in the bromocriptine group. After 6 months of follow-up overall patient and allograft survival was 97.7% and 91% respectively. Acute rejection episodes occurred in 31 patients (77.5%): 15 in the bromocriptine group vs 20 in the control group (n.s.). In each group eight patients experienced a cytomegalovirus infection. The incidence of severe bacterial infections (i.e. pneumonia and sepsis) was five and six respectively. The necessity of haemodialysis after transplantation was 3.1% in the patients on bromocriptine and 23% in those without. CONCLUSIONS: Suppression of circulating prolactin concentration by bromocriptine did not improve the clinical outcome of patients after kidney transplantation receiving cyclosporin and prednisolone.

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Subjects: Nephrology

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