Shin B C, Chung J H, Kim H L
Department of Internal Medicine, Division of Nephrology, Chosun University Hospital, Gwangju, Korea.
Transplant Proc. 2013 Oct;45(8):2968-9. doi: 10.1016/j.transproceed.2013.08.040.
Mycophenolate mofetil (MMF) is a potent immunosuppressive agent used to prevent acute and chronic rejection in kidney transplantation or for rescue therapy. One side effect of MMF is bone marrow toxicity, including leukopenia, which may necessitate drug withdrawal. We report 2 patients who underwent kidney transplantation and developed leukopenia while receiving MMF and safely switched to sirolimus. A 35-year-old woman underwent deceased donor kidney transplantation. She received basiliximab, tacrolimus, MMF, and a corticosteroid. On postoperative day (POD) 75, her white blood cell (WBC) count was 1800/μL. A 44-year-old women underwent deceased donor kidney transplantation and received basiliximab, tacrolimus, MMF, valganciclovir, and a corticosteroid. On POD 88, her WBC count was 1320/μL. MMF was switched to sirolimus, resulting in recovery of WBC count without rejection. Switch from MMF to sirolimus is safe and favorable in MMF-induced leukopenia in renal transplant recipient.
霉酚酸酯（MMF）是一种强效免疫抑制剂，用于预防肾移植中的急性和慢性排斥反应或进行挽救治疗。MMF的一个副作用是骨髓毒性，包括白细胞减少，这可能需要停药。我们报告了2例肾移植患者，他们在接受MMF治疗时出现白细胞减少，并安全地转换为西罗莫司治疗。一名35岁女性接受了死体供肾移植。她接受了巴利昔单抗、他克莫司、MMF和一种皮质类固醇。术后第75天（POD 75），她的白细胞（WBC）计数为1800/μL。一名44岁女性接受了死体供肾移植，并接受了巴利昔单抗、他克莫司、MMF、缬更昔洛韦和一种皮质类固醇。在POD 88时，她的WBC计数为1320/μL。将MMF转换为西罗莫司后，白细胞计数恢复，且未发生排斥反应。在肾移植受者中，从MMF转换为西罗莫司对于MMF诱导的白细胞减少是安全且有益的。
