CONVERSION FROM CYCLOSPORINE TO TACROLIMUS IN A PATIENT WITH PROLONGED ACUTE TUBULAR-NECROSIS

Acute tubular necrosis (ATN) is a common condition fol lowing cadaveri c renal transplantation with an incidence in many series of nearly 50 %. The aetiology is uncertain; however, it would appear to be related to damage to the transplant kidney either prior to retrieval, during c old preservation or during re-warming of the kidney at the time of ana stamotic construction. There is no specific therapy for ATN and treatm ent is comprised of an expectant policy with supportive dialysis and f luid restriction, Renal function improves in the majority of cases, th ough there may be delayed function for several weeks. We report a case of dialysis-dependent ATN that had persisted for 5 months following t ransplantation. Following conversion to tacrolimus there was immediate improvement in renal function, and after a month of tacrolimus therap y the patient was dialysis-independent.