CONVERSION OF CYCLOSPORINE (NEORAL??; CsA) TO MYCOPHENOLATE MOFETIL(CELLCEPT??; MMF) IN STABLE RENAL TRANSPLANT PATIENTS:

421 To investigate the efficacy and safety of the combination of MMF and prednisone (pred) in comparison to CsA and pred in renal transplant recipients we performed an open prospective study with the patient being his/her own control. Methods: 17 stable patients were investigated; all more than 6 months after renal transplantation (range 7-117 months). At start of the study they used CsA (mean trough level 130±30 μg/L) and pred 7.5 mg od. After the first measurements MMF 1 gr bid was given and CsA slowly tapered to a mean trough level of 50 ± 10 μg/L. When no signs of rejection were noted after a period of 8 wks at low dose CsA, CsA was slowly withdrawn. At three time points patients were investigated: at start with a normal dose of CsA, after 8 wks of low dose CsA and 8 wks after stopping CsA. Glomerular filtration rate (GFR), renal blood flow (RBF) and renal vascular resistance (RVR) were measured. Furthermore, 24 h blood pressure (BP), blood uric acid and the lipid profile was measured. Results: 15 of the 17 patients could be converted successfully. One showed a steroid responsive rejection after 16 wks of MMF therapy, being on low dose CsA for 7wks. Another patient was withdrawn after 9 weeks of MMF because of severe diarrhoea.TableConclusion: In the majority of patients conversion of CsA/pred to MMF/pred was safe and gave an improvement of renal hemodynamics, BP and serum uric acid. The effects on LDL cholesterol were not significant.