EFFECTS OF CYCLOSPORINE-A WITHDRAWAL ON RENAL-FUNCTION AND RENAL STIMULATION IN LIVER-TRANSPLANT PATIENTS TREATED WITH TRIPLE-DRUG IMMUNOSUPPRESSION FOR OVER 2 YEARS

The influence of CsA withdrawal on the glomerular filtration rate (GFR ) and the effective renal plasma flow (ERPF) was prospectively studied in nine stable liver transplant recipients. Before CsA withdrawal (te st 1), and 6 months thereafter (test 2) the renal function was determi ned by measuring GFR and the ERPF with I-125-iothalamate and I-131-hip puran respectively. The renal function was also stimulated with dopami ne, with an amino-acid infusion and a combination of both. After CsA w ithdrawal the GFR increased, median from 74 ml min(-1) to 90 ml min(-1 ), (P < 0.04). The ERPF also increased, median from 310 ml min(-1) to 380 ml min(-1), (P < 0.03). In test 1 as well as in test 2 the renal f unction could be stimulated, especially with dopamine. GFR and ERPF im proved, even after more than 2 years of CsA treatment. These results s uggest that long-term CsA treatment impairs the renal function, though in these liver transplant patients CsA treatment did not prevent affe rent and efferent arteriolar vasodilatation after renal stimulation. T his reversible intrarenal vasoconstriction during CsA treatment may pr edict renal improvement after CsA withdrawal.