MYCOPHENOLATE MOFETIL IN RENAL-TRANSPLANT RECIPIENTS WITH CYCLOSPORINE-ASSOCIATED NEPHROTOXICITY - A PRELIMINARY-REPORT

Background There is a great concern over cyclosporine (CsA) nephrotoxi city in renal transplant recipients, and the effects of conversion fro m CsA to azathioprine (AZA) remain controversial. Large studies have d emonstrated that mycophenolate mofetil (MMF), the morpholinoethyl este r of mycophenolic acid, is superior to AZA as a posttransplant immunos uppressant. Methods. Six patients with isolated biopsy-proven CsA neph rotoxicity were converted from CsA-AZA to MMF. Results. Mean follow-up was 12+/-2 months. No patient experienced acute rejection. The mean s erum creatinine concentration decreased from 225 +/- 58 to 159 +/- 66 mu mol/L (P < 0.0005), Hyperlipidemia and blood pressure improved afte r CsA withdrawal. Conclusion. In a selected transplant population with biopsy-proven CsA nephrotoxicity, CsA withdrawal with a concomitant s witch from AZA to MMF seems to be safe and allows a significant improv ement of renal function.