J Korean Surg Soc.
2008 Apr;74(4):248-254.
Phased Reduction of Cyclosporine Combined with Mycophenolate Mofetil in Renal Transplant Recipients: Three-year Results of a Prospective Study
- Affiliations
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- 1Department of Surgery, Gacheon Medical School, Gil Medical Center, Incheon, Korea.
- 2Department of Surgery, Seoul National University College of Medicine, Seoul National University, Seoul, Korea. jwhamd@snu.ac.kr
- 3Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University, Seoul, Korea.
- 4The Transplantation Research Institute, Seoul National University, Seoul, Korea.
Abstract
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PURPOSE: Although cyclosporine (CsA) improves short-term renal graft outcomes, many paradigms reduce or withdraw this drug because of its nephrotoxicity. However, inadequate immunosuppression with azathioprine led to little success. We conducted a prospective study to define the prolonged effect of CsA reduction in stable renal transplant recipients with mycophenolate mofetil (MMF).
METHODS
Thirty-nine primary renal transplant recipients were divided into two cohorts, the AZA (N=13) and the MMF cohort (N=26). Both cohorts were allowed to reduce the CsA dose up to 50% of baseline within 3 to 4 months of conversion to AZA or MMF. Graft function, clinical parameters, and adverse events were monitored for up to 3 years.
RESULTS
Ccr gradually deteriorated in the AZA cohort, but was stable in the MMF cohort. There was no episode of acute rejection or graft loss observed in either cohort.
CONCLUSION
The CsA dose can be reduced in combination with MMF treatment in stable renal transplant recipients after 2 years of transplantation, resulting in beneficial effects on Ccr, lipid profiles, and blood pressure.