Mycophenolate mofetil in renal transplant recipients with cyclosporine-associated nephrotoxicity: a preliminary report.
BACKGROUND
There is a great concern over cyclosporine (CsA) nephrotoxicity in renal transplant recipients, and the effects of conversion from CsA to azathioprine (AZA) remain controversial. Large studies have demonstrated that mycophenolate mofetil (MMF), the morpholinoethyl ester of mycophenolic acid, is superior to AZA as a posttransplant immunosuppressant.


METHODS
Six patients with isolated biopsy-proven CsA nephrotoxicity were converted from CsA-AZA to MMF.


RESULTS
Mean follow-up was 12+/-2 months. No patient experienced acute rejection. The mean serum creatinine concentration decreased from 225+/-58 to 159+/-66 micromol/L (P<0.0005). Hyperlipidemia and blood pressure improved after CsA withdrawal.


CONCLUSIONS
In a selected transplant population with biopsy-proven CsA nephrotoxicity, CsA withdrawal with a concomitant switch from AZA to MMF seems to be safe and allows a significant improvement of renal function.
Ducloux
D
D
Department of Nephrology and Renal Transplantation, Hopital Saint Jacques, Besançon, France.
Fournier
V
V
Bresson-Vautrin
C
C
Rebibou
J M
JM
Billerey
C
C
Saint-Hillier
Y
Y
Chalopin
J M
JM
D000368:Aged; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000506:poisoning*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects*; D016030:Kidney Transplantation; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011182:Postoperative Care; D019233:Retreatment
D007166:Immunosuppressive Agents; D008055:Lipids; D016572:Cyclosporine; D003404:Creatinine; D009173:Mycophenolic Acid