MYCOPHENOLATE MOFETIL, AN ALTERNATIVE TO CYCLOSPORINE A FOR LONG-TERM IMMUNOSUPPRESSION IN KIDNEY TRANSPLANTATION?1,2

Publisher Website
Google Scholar
Abstract
Mycophenolate-mofetil (MMF) is a nonnephrotoxic immunosuppressant most often used in combination with cyclosporine A (CsA) and prednisone (Pred).This study reports the outcome of 17 adult renal recipients whose immunosuppressive regimen was changed from CsA-Pred to MMF-Pred because of CsA nephrotoxicity. CsA nephrotoxicity was diagnosed in all patients based on suggestive histopathological lesions on a renal biopsy. Sixteen patients had deteriorating graft function and 1 had isolated persistent proteinuria. Immunosuppressive therapy was changed 57±32 months posttransplant. After replacement of CsA by MMF, a reduction in serum creatinine was observed in all patients (mean 26±17%). This reduction was maintained 20±8 months after the change in therapy without any episodes of acute rejection. Serum lipids and blood pressure also decreased significantly. This study demonstrates that MMF-Pred can be an effective long-term immunosuppressive treatment alternative for renal transplant patients experiencing CsA nephrotoxicity. Such treatment may result in improved graft function, and better control of hypertension and hyperlipidemia.