Conversion from azathioprine [correction of azathioprina] to mycophenolate mofetil in pediatric renal transplant recipients with chronic rejection.

摘要: BACKGROUND Chronic rejection is the leading cause of graft failure. Both nonimmunological and immunological mechanisms contribute to this pathology. METHODS We studied changes in kidney function, mixed lymphocyte culture, cell-mediated lympholysis, serum HLA class I antigens, cytotoxic antibodies, population before after 6 months follow-up 22 pediatric renal transplanted patients. The immunosuppressive protocol used was: cyclosporine, azathioprine, corticosteroids. Eight patients demonstrated chronic (by biopsy), group I; eight had no clinical evidence and/or acute rejection, II. Substitution mycophenolate mofetil (MMF) (600 mg/m2 bid for azathioprine was done groups Another six with did not receive MMF, III. RESULTS Creatinine clearance increased (44+/-5 vs. 51.1+/- ml/min/1.73 m2, P<0.03) but it decreased III (30+/-3 25+/-2, P<0.01). Urinary protein excretion only (0.3+/-0.03 0.06+/-0.03 g/24 hr, P<0.03). During MMF therapy antidonor culture 62 70% (P<0.05) Cell-mediated lympholysis against donor 65% I. toward control cells 54% (P<0.01) Serum from 0.7+/-0.1 0.5+/-0.1 microl/ml, P<0.05, CD19+ 7.9+/-1.1 5.6+/-0.8%, 7.8+/-1.2 5.5+/-0.9%, II, respectively. CD16+ 5.7+/-1.1 8.6+/-1.3 CONCLUSIONS Our data suggest that substituting leads an improvement immunosuppression function children on-going rejection.