title: Discontinuation of calcineurin inhibitors in heart transplant patients with end stage renal insufficiency as an alternative model of immunosuppression.
abstract: Five heart recipients were followed up with mycophenolate mofetil and low dose cyclosporine due to progressive severe chronic postcyclosporine renal failure. Cyclosporine was gradually withdrawn and finally eliminated from immunosuppressive regimen to slow the rate of renal function loss. Improvement of renal function was observed. In the follow up after cyclosporine elimination no risk increase of acute rejection and no deterioration of left ventricle function was observed. Non-calcineurin inhibitors model in heart recipients can be the treatment of choice (but only in very selective cases) in patients with severe chronic renal insufficiency.
authors.affiliation: Department of Cardiovascular and Transplantation Surgery, Institute of Cardiology, Jagiellonian University, Krakow, Poland. kardiochir@szpitaljp2.krakow.pl
authors.forename: Sadowski
authors.initials: S
authors.lastname: Jerzy
authors.forename: Karol
authors.initials: K
authors.lastname: Wierzbicki
authors.forename: Bogusław
authors.initials: B
authors.lastname: Kapelak
authors.forename: Janusz
authors.initials: J
authors.lastname: Konstanty
authors.forename: Piotr
authors.initials: P
authors.lastname: Przybyłowski
authors.forename: Sławomir
authors.initials: S
authors.lastname: Wójcik
authors.forename: Rafał
authors.initials: R
authors.lastname: Drwiła
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Wróbel
authors.forename: Jacek
authors.initials: J
authors.lastname: Piatek
mesh_terms: D000328:Adult; D000368:Aged; D019703:Calcineurin / Q000378:metabolism; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006084:Graft Rejection / Q000188:drug therapy / Q000276:immunology; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D019703:Calcineurin; D009173:Mycophenolic Acid