Salvage therapy with mycophenolate mofetil for lung transplant bronchiolitis obliterans: importance of dosage.
BACKGROUND
Bronchiolitis obliterans (BO) is the most important long-term complication of lung transplantation. Treatment of this condition is often unsuccessful.


METHODS
A patient presented with early BO. Despite OKT3 and the addition of methotrexate, the patient needed persistently high doses of prednisone to maintain lung function at a moderate level. Only the substitution of azathioprine by mycophenolate mofetil (MMF, 3 g/day) made it possible to reduce the dose of prednisone.


RESULTS
Reduction of the dose of MMF to 2 g/day resulted in a deterioration of lung function, which improved impressively after MMF was increased again to 3 g/day.


CONCLUSIONS
MMF may be a valuable therapy for lung transplant BO. However, the use of a high dose, i.e., 3 g/day, may be crucial.
Speich
R
R
Department of Internal Medicine, University Hospital Zurich, Switzerland. klinspr@usz.unizh.ch
Boehler
A
A
Thurnheer
R
R
Weder
W
W
D000328:Adult; D001989:Bronchiolitis Obliterans / Q000188:drug therapy* / Q000209:etiology; D003550:Cystic Fibrosis / Q000601:surgery; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016040:Lung Transplantation / Q000009:adverse effects*; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016879:Salvage Therapy
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid