Mycophenolate mofetil in renal transplant recipients with cyclosporine-associated nephrotoxicity - A preliminary report

Background There is a great concern over cyclosporine (CsA) nephrotoxicity in renal transplant recipients, and the effects of conversion from CsA to azathioprine (AZA) remain controversial. Large studies have demonstrated that mycophenolate mofetil (MMF), the morpholinoethyl ester of mycophenolic acid, is superior to AZA as a posttransplant immunosuppressant. Methods. Six patients with isolated biopsy-proven CsA nephrotoxicity were converted from CsA-AZA to MMF. Results. Mean follow-up was 12+/-2 months. No patient experienced acute rejection. The mean serum creatinine concentration decreased from 225 +/- 58 to 159 +/- 66 mu mol/L (P < 0.0005), Hyperlipidemia and blood pressure improved after CsA withdrawal. Conclusion. In a selected transplant population with biopsy-proven CsA nephrotoxicity, CsA withdrawal with a concomitant switch from AZA to MMF seems to be safe and allows a significant improvement of renal function.