High-Dose Mycophenolate Mofetil in the Treatment of Posttranspiant Giomerular Disease in the Allograft: A Case Series

摘要

Background: Giomeruiar disease is an important cause of allograft loss. Treatment regimens for posttranspiant giomeruiar disease are not well defined. Several reports have demonstrated that mycophenolate mofetil (MMF) is effective in treating native kidney giomeruiar disease. The effects of MMF are dose related. Therefore, we hypothesized that high-dose MMF (3 g/day) would be effective in treating giomeruiar disease in the allograft, minimizing the need for intravenous steroids and/or cyclophosphamide. This case series describes the results of the use of high-dose MMF in 6 patients. Methods: High-dose MMF (3 g/day) was used to treat biopsy-proven giomeruiar disease (focal segmental glomeruloscle-rosis, membranoproliferative glomerulonephritis, prolif-erative lupus nephritis, and perinuclear antineutrophil cytoplasmic antibodies glomerulonephritis) in 6 renal transplant recipients. Patients were offered this treatment if they had failed or did not tolerate standard treatment regimens. Remission was defined by a decrease or stabilization of serum creatinine, decrease in proteinuria and, where applicable, improvement in immunological markers of disease. Results: All 6 patients had disease remission after starting MMF with the most common side effect being leukopenia, which responded to dose reduction. Conclusions: High-dose MMF may be an effective agent in treating giomeruiar disease in the allograft.