P123 (RA6346)
Conversion from Cyclosporin (CyA) to Mycophenolate-based Immunosuppression
Prolongs Kidney Graft Survival in Patients with Chronic Allograft Nephropathy
(CAN)
A Boswell, L Evans and K Rigg
Transplant Clinic, Nottingham renal/transplant unit, Nottingham city hospital, Hucknall
Rd, Nottingham, NG5 1PB, United Kingdom
Management strategies for patients with CAN remains unclear. We have previously
reported improved renal function in patients with CAN upon conversion from CyA to
mycophenolate mofetil (MMF). In this report we describe the effect of conversion from
CyA to MMF on long-term
renal function and graft survival.
The data of 50 patients with biopsy proven CAN converted from CyA to MMF were
analysed. The estimated time until graft failure (ETGF) based on 1/serum
creatinine was calculated using a line-of-best-fit model (shown in graph 1).
Mean time from transplant to biopsy proven CAN was 6.3yrs (16.6-0.4yrs). Mean follow
up
time was 28 months (1-60 months).
In 7 patients (14%) ETGF could not be predicted. There were 2 graft failures in
this group.
The ETGF was predictable in 43 (86%) of the patients. In these patients 18 (42%)
would have lost their graft by the end of the first year. A further 19 (44%) and
2 (5%) would have lost their grafts by the end of the 2nd and 3rd years
respectively.
At the time of latest review a total of 36(84%) had graft function beyond ETGF. One graft
(2%) was lost within ETGF and 4 patients died with functioning grafts. Four patients (9%)
had MMF withdrawn due to intolerable side effects of medication but grafts are still
functioning.
In conclusion our model of predicted graft loss shows continuous improvement in
renal function and graft survival over time in patients with CAN converted from
CyA to MMF.