Salvage therapy with mycophenolate mofetil for lung transplant bronchiolitis obliterans: importance of dosage.

Abstract

BACKGROUND:

Bronchiolitis obliterans (BO) is the most important long-term complication of lung transplantation. Treatment of this condition is often unsuccessful.

METHODS:

A patient presented with early BO. Despite OKT3 and the addition of methotrexate, the patient needed persistently high doses of prednisone to maintain lung function at a moderate level. Only the substitution of azathioprine by mycophenolate mofetil (MMF, 3 g/day) made it possible to reduce the dose of prednisone.

RESULTS:

Reduction of the dose of MMF to 2 g/day resulted in a deterioration of lung function, which improved impressively after MMF was increased again to 3 g/day.

CONCLUSIONS:

MMF may be a valuable therapy for lung transplant BO. However, the use of a high dose, i.e., 3 g/day, may be crucial.

• Authors: R Speich, A Boehler, R Thurnheer, W Weder
• Journal: Transplantation (Transplantation) Vol. 64 Issue 3 Pg. 533-5 (Aug 15 1997) ISSN: 0041-1337 [Print] United States
• PMID: 9275125 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Immunosuppressive Agents
• Mycophenolic Acid

Topics

• Adult
• Bronchiolitis Obliterans (drug therapy, etiology)
• Cystic Fibrosis (surgery)
• Dose-Response Relationship, Drug
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Lung Transplantation (adverse effects)
• Mycophenolic Acid (administration & dosage, analogs & derivatives, therapeutic use)
• Salvage Therapy