Jain Ashokkumar, Vekatramanan Raman, Eghtesad Bijan, Gadomski Mary, Mohanka Ravi, Marcos Amadeo, Fung John
Department of Surgery, Transplant Division, Strong Memorial Hospital, University of Rochester, Rochester, NY 14642, USA.
Transplantation. 2005 Sep 27;80(6):859-64. doi: 10.1097/01.tp.0000173994.63299.63.
Mycophenolate mofetil (MMF) has no known nephrotoxicity. This report examines the outcome in patients who received MMF for renal impairment on tacrolimus-based immunosuppression. From 1995 to 1996, twelve liver transplantation (LTx) patients (mean age 54.6 years) with serum creatinine >1.8 mg/dl were included in the study. MMF was introduced and tacrolimus dose was reduced by 30-50%. Each patient was followed for 6 years. Renal function showed improvement in seven patients, deterioration in four, and no change in one patient. Overall mean serum creatinine decreased from 2.5 to 1.9 mg/dl at 6 months but increased to 2.2 mg/dl at 18 to 24 months. After that, renal function remained stable for 72 months. Iothalamate clearance showed 18.5% improvement at 1 year. Three patients developed renal failure. Six patients died in the follow-up period. Addition of MMF with reduced tacrolimus dose resulted in sustained improvement in renal function in 58% of patients.
霉酚酸酯（MMF）尚无已知的肾毒性。本报告研究了在以他克莫司为基础的免疫抑制治疗中接受MMF治疗肾功能损害患者的预后情况。1995年至1996年，12例血清肌酐>1.8mg/dl的肝移植（LTx）患者（平均年龄54.6岁）纳入本研究。开始使用MMF并将他克莫司剂量减少30 - 50%。每位患者随访6年。7例患者肾功能改善，4例恶化，1例无变化。总体平均血清肌酐在6个月时从2.5mg/dl降至1.9mg/dl，但在18至24个月时升至2.2mg/dl。此后，肾功能保持稳定72个月。碘他拉酸盐清除率在1年时提高了18.5%。3例患者出现肾衰竭。6例患者在随访期间死亡。添加MMF并减少他克莫司剂量使58%的患者肾功能持续改善。
