No abstract

Mycophenolate mofetil (MMF) is a new immunosuppressant developed for the prevention and treatment of acute renal rejection after transplantation. Diarrhea is the most frequent side effect observed during treatment with MMF. Its pathogenic mechanisms remain unknown. We describe a case of severe diarrhea due to villous atrophy in a renal transplant recipient during treatment with MMF. The patient was free of symptoms before MMF. Villous atrophy disappeared a few months after MMF withdrawal.

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.

No abstract

Because recent large studies have demonstrated that mycophenolate mofetil (MMF) is superior to azathioprine (AZA) as a posttransplant immunosuppressant, it has been speculated that MMF could have a cyclosporin (CsA)-sparing effect in renal transplant recipients with chronic allograft dysfunction. Between April 1996 and October 1998, 31 patients with chronic allograft dysfunction were assigned to have conversion from AZA to MMF with concomitant CsA withdrawal. Patient and graft outcomes were analysed. Mean follow-up time after MMF conversion was 27 * 11 months. Serum creatinine concentration (sCt) significantly decreased after conversion and remained stable at the end of followup (227 * 3 1 pmol/l vs. 185 It 50 pmol/l; P < 0.0005). Mean variation in sCt was -24% after conversion, whereas it was +20% in the year before conversion ( P < 0.001). There was a significant inverse relationship between proteinuria at baseline and improvement in renal function (r = -0.35; P = 0.01). Proteinuria increased during follow-up (0.79 It 0.6 vs.