In order to assess the immunosuppressive potentials of 15-deoxyspergualine (15-DS) in a preclinical experiment, heterotopi cardiac (n=27, group I) and classic renal (n=25, group II) allotransplantations were performed in Chacma baboons. The following immunosuppressive regimens were applied: Groups IB and IIB were treated with 15-DS alone (4 mg/kg/day) for p.o. days 0–9. Groups IC and IIC were treated with cyclosporine A (10–40 mg/kg/day) for p.o. days 0–30. Groups ID and IID received a combination of 15-DS (for p.o. days 0–9) and CsA (for p.o. days 0–30). Groups IA and IIA served as control and received no medication. The mean graft survival was 11.0 days for group IA, 28.2 days for group IB (P<0.05; IB vs. IA), 32.4 days for group IC, and 43.1 days for group ID (P<0.025; ID vs. IA). After renal transplantation, the corresponding figures were 12.3 days for group IIA, 8.5 days for group IIB, 30.4 days for group IIC and 148.9 days for group IID (P<0.025; IID vs. IIA). After cardiac and renal transplantation, acute rejection was the main cause of graft failure. Treatment-related side effects, mainly gastrointestinal complications, were observed only in primates, who were treated with 15-DS alone. After cardiac transplantation, permanent graft nonreactivity was not achieved, but a delayed rejection occurred within a mean of 21.8 days after immunosuppression had been stopped. Following renal transplantation, graft nonreactivity was also not achieved in groups IIB and IIC. In group IID, however, 4 of 8 animals (50%) were graft-tolerant 340, 256, 244, and 164 days after treatment discontinuation. Thus, the combination of 15-DS and CsA led to a significant prolongation of graft survival in both groups. Long-term nonreactivity was achieved only after renal transplantation, when initially treated with 15-DS and CsA. © 1990 by Williams & Wilkins.
