Improvement of drug-induced chronic renal failure in lung transplantation

Background. Nephrotoxicity is a frequently encountered adverse effect of ca lcineurin inhibitors (cyclosporine and tacrolimus)-combined immunosuppressi ve regimens. Methods. We have compared the glomerular filtration rate in 14 patients who underwent lung transplantation, before and after replacement of azathiopri ne by mycophenolate mofetil and reduction of associated calcineurin inhibit ors doses. Results. After a mean follow-up of 16+/-4 months with the modified immunosu ppressive regimen, the mean glomerular filtration rate increased by 20% wit h no change in lung function. Conclusion. By its strong immunosuppressive effect, mycophenolate mofetil a llows the decrease of associated calcineurin inhibitor doses, with subseque nt improvement of renal function without jeopardizing the transplanted lung .