EFFECT OF CYCLOSPORINE WEANING ON GLOMERULAR-FILTRATION RATE IN RENAL-TRANSPLANTATION

The objective of this study was to determine the effect of weaning cyc losporin on glomerular filtration rate in 55 renal transplant patients from the Renal Transplant Unit at the Royal Victoria Hospital. Men or women, older than 20 years of age, who received cadaveric or living-r elated renal transplant and who were treated with the complete cyclosp orin protocol, were included. Weaning of cyclosporin was started 15 da ys after the prednisone dose was reduced to 15 mg/day and this weaning process was completed at day 105 posttransplant. The daily cyclospori n dose was decreased by 25 mg once every 2 weeks, and completely withd rawn after treatment when 50 mg/day was tolerated for 2 weeks. The dur ation of the weaning process varied because of fixed dose reduction. R enal graft function was assessed by plasma creatinine concentrations. We used the time point of cyclosporin discontinuation as time zero. Se rum creatinine decreased over the time from 150 +/- 61 mmol/l at time zero to 100 +/- 18 mmol/l in the last determination, while GFR had a s ignificant increment from 66 +/- 18 to 77 +/- 20. A total of 4 rejecti on episodes were observed 6 months after cyclosporin discontinuation. There were no graft failures and deaths. To determine predictors of im provement, we carried out multiple regression analysis and we found th at prophylactic antilymphocyte globulin and the onset of graft functio n after transplantation were predictors.