title: Salvage therapy with mycophenolate mofetil for lung transplant bronchiolitis obliterans: importance of dosage.
abstract: 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.
authors.affiliation: Department of Internal Medicine, University Hospital Zurich, Switzerland. klinspr@usz.unizh.ch
authors.forename: R
authors.initials: R
authors.lastname: Speich
authors.forename: A
authors.initials: A
authors.lastname: Boehler
authors.forename: R
authors.initials: R
authors.lastname: Thurnheer
authors.forename: W
authors.initials: W
authors.lastname: Weder
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid