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

Transplantation. 1997 Aug 15;64(3):533-5. doi: 10.1097/00007890-199708150-00027.

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

  • Immunosuppressive Agents
  • Mycophenolic Acid