I. Houde et al., Mycophenolate mofetil, an alternative to cyclosporine A for long-term immunosuppression in kidney transplantation?, TRANSPLANT, 70(8), 2000, pp. 1251-1253
Background. Mycophenolate-mofetil (MMF) is a non-nephrotoxic immunosuppress
ant 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.
Methods. CsA nephrotoxicity was diagnosed in all patients based on suggesti
ve histopathological lesions on a renal biopsy. Sixteen patients had deteri
orating graft function and 1 had isolated persistent proteinuria. Immunosup
pressive therapy was changed 57 +/- 32 months posttransplant.
Results. After replacement of CsA by MMF, a reduction in serum creatinine w
as observed in all patients (mean 26 +/- 17%). This reduction was maintaine
d 20 +/- 8 months after the change in therapy without any episodes of acute
rejection. Serum lipids and blood pressure also decreased significantly.
Conclusion. 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 graf
t function, and better control of hypertension and hyperlipidemia.