Improvement of chronic renal failure after introduction of mycophenolate mofetil and reduction of cyclosporine dose
G. Rábago (1), N. Manito (2), J. Palomo (3), J. M. Arizón (4), J. Delgado (5), L. Almenar (6), M. Crespo (7), E. Lage (8) and L. Pulpón (9)
(1) University of Navarra, Pamplona, Spain
(2) Hospital de Bellvitge, Spain
(3) Hospital Gregorio Marañón, Spain
(4) Hospital Reina Sofía, Córdoba, Spain
(5) Hospital 12 de Octubre, Madrid, Spain
(6) Hospital la Fe, Valencia, Spain
(7) Hospital Juan Canalejo, La Coruña, Spain
(8) Hospital Ntra. Sra del Rocío, Sevilla, Spain
(9) Clínica Puerta de Hierro, Madrid, Spain
Chronic renal insufficiency remains a long-term complication in heart transplant patients (HT) clearly associated with the use of ciclosporine a (Csa).
The introduction of new immunosuppressive drugs like mycophenolate mofetil (MMF) allows us to decrease the dose of Csa and their nephrotoxic effects. We designs a prospective multicentric study where we include heart transplant patients treated with Csa over eighteen months and with renal insufficiency (creatinine . 1,4 mg/dl in two previous determination).
We introduce MMF and them decrease the dose of Csa keeping the trough levels under 100 ng/ml. Primary endpoint was renal function improvement and secondary endpoint were rejection episode, infection and metabolic disorders. Seventy-four patients (66 males and 8 females) were include in the study with a mean age of 59610 years. Mean time between HT and inclusion in the study were 5,8 years (range 1,5 to 12,6 years).
CITA DEL ARTÍCULO J Heart Lung Transplant. 2001 Feb;20(2):193