Calcineurin-inhibitor related nephrotoxicity-reversibility in paediatric liver transplant recipients

Citation
Mm. Aw et al., Calcineurin-inhibitor related nephrotoxicity-reversibility in paediatric liver transplant recipients, TRANSPLANT, 72(4), 2001, pp. 746-749
Citations number
11
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
TRANSPLANTATION
ISSN journal
00411337 → ACNP
Volume
72
Issue
4
Year of publication
2001
Pages
746 - 749
Database
ISI
SICI code
0041-1337(20010827)72:4<746:CRNIPL>2.0.ZU;2-7
Abstract
Aim. To study the efficacy of mycophenolate mofetil. (MMF) as renal rescue in paediatric liver transplant recipients with calcineurin-inhibitor- (CI) related nephrotoxicity. Methods. Pediatric liver transplant recipients with stable graft function a nd a glomerular filtration rate (GFR) < 80 ml/min/1.73 m(2) were enrolled. MMF was introduced at 20 mg/kg/day and increased to 40 mg/kg/ day after 1 w eek. CI dose was then reduced 6 weeks to achieve blood levels 25% of baseli ne. GFR was reassessed after 6 and 12 months. Results. Fourteen children with a median (range) interval from transplant o f 57 (4-111) months were studied. Their median (range) GFR in ml/min/1.73 m (2) increased from a baseline of 52 (31-71), to 69 (38-111) and 73 (35-98) at 6 and 12 months, respectively (P=0.00014). Side effects of MMF include l eucopaenia in two and backache in one, two of whom discontinued MMF. Acute allograft rejection occurred in three children. All 14 are well with a medi an (range) follow-up of 24 (14-38) months from MMF introduction. Conclusion. MMF allows the recovery of renal function from CI related nephr otoxicity in more than 70% of paediatric liver transplant recipients with r enal impairment.