Papatheodoridis G V, O'Beirne J, Mistry P, Davidson B, Rolles K, Burroughs A K
Liver Transplantation Unit, Royal Free Hospital, London, United Kingdom.
Transplantation. 1999 Jul 15;68(1):155-7. doi: 10.1097/00007890-199907150-00029.
Cyclosporine is the most common maintenance immunosuppressant in liver transplants patients, but it is often associated with nephrotoxicity.
We evaluated the safety and efficacy of monotherapy with mycophenolate mofetil (1 g twice daily) in five stable liver transplant patients with cyclosporine-induced renal impairment despite reduction of cyclosporine to subtherapeutic levels. Follow-up was 8.4+/-2.4 (range: 6-12) months.
No major side effects have been observed to date. Serum creatinine levels were significantly reduced from a median of 201 micromol/L before to 142 micromol/L at 3 months after mycophenolate (P=0.04) and remained low at 6 months. New onset cellular rejection occurred in only one patient after 3 months on mycophenolate monotherapy, and it responded completely to an intravenous course of methylprednisolone.
Monotherapy with mycophenolate mofetil in a dose of 1 g twice daily seems to significantly improve cyclosporine-induced renal impairment in stable liver transplant patients without major side effects or significant risk of rejection.
环孢素是肝移植患者中最常用的维持性免疫抑制剂，但它常与肾毒性相关。
我们评估了霉酚酸酯（每日两次，每次1克）单药治疗对5例稳定的肝移植患者的安全性和有效性，这些患者尽管已将环孢素剂量降至亚治疗水平，但仍存在环孢素诱导的肾功能损害。随访时间为8.4±2.4（范围：6 - 12）个月。
迄今为止未观察到重大副作用。血清肌酐水平从霉酚酸酯治疗前的中位数201微摩尔/升显著降至3个月时的142微摩尔/升（P = 0.04），并在6个月时保持较低水平。仅1例患者在霉酚酸酯单药治疗3个月后发生新的细胞排斥反应，对静脉注射甲泼尼龙疗程完全有效。
每日两次，每次1克剂量的霉酚酸酯单药治疗似乎能显著改善稳定肝移植患者中环孢素诱导的肾功能损害，且无重大副作用或显著的排斥风险。
