Abstract
Background. In the first year after renal allograft transplantation, triple therapy immunosuppression with cyclosporin (CsA), prednisone (P), and mycophenolate mofetil (MMF) is superior to a triple therapy treatment that includes azathioprine (AZA) instead of MMF. Whether long‐term treatment with CsA‐P‐MMF is better than treatment with CsA‐P‐AZA is a matter of debate, as 3‐year graft survival is similar in MMF‐ and AZA‐treated patients. The purpose of the present study was to examine the short‐term effect of changing MMF to AZA in low‐risk renal allograft recipients 6 months after transplantation. Method. This was a randomized, open‐label single‐centre study, recruiting 48 low risk renal allograft recipients on CsA‐P‐MMF therapy 6 months after transplantation, comparing the outcome with continued MMF treatment (2 g b.i.d.) (group A, n=22) or switching MMF to AZA (1 mg/kg) treatment (group B, n=26). Results. The outcome after a 6‐months follow‐up of patients in group A and group B was similar. Treatment failure rates (defined as clinically diagnosed acute rejection episodes) were 4.5% in group A and 3.8% in group B. There were no patient deaths and no graft failures during the 6‐months observation period. Graft function was excellent and similar in both groups. Conclusion. Replacing MMF with AZA 6 months after transplantation in low‐risk renal allograft recipients is safe and is not associated with altered graft function in the short term
Wüthrich, Rudolf P