霉酚酸酯用于肾移植受者伴环孢素相关肾毒性：初步报告。

Mycophenolate mofetil in renal transplant recipients with cyclosporine-associated nephrotoxicity: a preliminary report.

作者信息

Ducloux D, Fournier V, Bresson-Vautrin C, Rebibou J M, Billerey C, Saint-Hillier Y, Chalopin J M

机构信息

Department of Nephrology and Renal Transplantation, Hopital Saint Jacques, Besançon, France.

出版信息

Transplantation. 1998 Jun 15;65(11):1504-6. doi: 10.1097/00007890-199806150-00019.

DOI:10.1097/00007890-199806150-00019

Abstract

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 micromol/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.

摘要

背景

肾移植受者中环孢素（CsA）肾毒性备受关注，从CsA转换为硫唑嘌呤（AZA）的效果仍存在争议。大型研究表明，霉酚酸吗啉乙酯（MMF）作为移植后免疫抑制剂优于AZA。

方法

6例经活检证实为CsA肾毒性的患者从CsA-AZA转换为MMF。

结果

平均随访时间为12±2个月。无患者发生急性排斥反应。血清肌酐平均浓度从225±58微摩尔/升降至159±66微摩尔/升（P<0.0005）。停用CsA后高脂血症和血压有所改善。

结论

在经活检证实为CsA肾毒性的特定移植人群中，停用CsA并同时从AZA转换为MMF似乎是安全的，且能显著改善肾功能。