Cyclophosphamide and whole organ transplantation in human beings.

DURING THE LAST DECADE, only three major immunosuppressants have been used extensively for whole organ transplantation, namely azathioprine, prednisone, and heterologous antilymphocyte globulin. None of these agents is sufficiently potent to permit consistent success when used alone in human beings. Consequently, the drugs have been administered in the double combination of azathioprine and prednisone or more recently in a triple combination of all three agents. This article was undertaken to describe our experience with cyclophosphamide, a fourth major immunosuppressive drug which was given from the outset instead of azathioprine to 40 whole organ recipients and which was used to replace azathioprine at varying times after transplantation in another 54 patients. The results have shown cyclophosphamide to be equivalent to azathioprine in its therapeutic role and effectiveness.