Discontinuation of calcineurin inhibitors in heart transplant patients with end stage renal insufficiency as an alternative model of immunosuppression

Przegl Lek. 2006;63(12):1256-8.

Abstract

Five heart recipients were followed up with mycophenolate mofetil and low dose cyclosporine due to progressive severe chronic postcyclosporine renal failure. Cyclosporine was gradually withdrawn and finally eliminated from immunosuppressive regimen to slow the rate of renal function loss. Improvement of renal function was observed. In the follow up after cyclosporine elimination no risk increase of acute rejection and no deterioration of left ventricle function was observed. Non-calcineurin inhibitors model in heart recipients can be the treatment of choice (but only in very selective cases) in patients with severe chronic renal insufficiency.

MeSH terms

  • Adult
  • Aged
  • Calcineurin / metabolism
  • Calcineurin Inhibitors*
  • Cyclosporine / administration & dosage
  • Cyclosporine / adverse effects*
  • Dose-Response Relationship, Drug
  • Follow-Up Studies
  • Glomerular Filtration Rate / drug effects
  • Graft Rejection / drug therapy
  • Graft Rejection / immunology
  • Heart Transplantation / immunology*
  • Humans
  • Immune Tolerance / drug effects
  • Immunosuppression Therapy / methods*
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Male
  • Middle Aged
  • Mycophenolic Acid / administration & dosage
  • Mycophenolic Acid / analogs & derivatives*
  • Renal Insufficiency, Chronic / chemically induced*
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / prevention & control
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Cyclosporine
  • Calcineurin
  • Mycophenolic Acid