HOW NEPHROTOXIC IS CYClOSPORIN A1 Renal function monitored in liver and kidney transplant patients Renal function monitoring showed abnormalities on 7 occasions in 6 of 12 liver transplant recipients on cyclosporin A. Nephrotoxicity occurred after 13-22 days of treatment with 11-20mg/kg/ day. When the daily dose was reduced to 9. 2mg/ kg (mean), kidney function returned to normal. There were no signs ofliver rejection with the lower doses. When kidney transplant recipients (from among 66) suspected of having nephrotoxicity were switched from cyclosporin A and prednisone to azathioprine and prednisone, graft function improved in 3, but the fourth transplant was irreversibly rejected 13 days later. Thus, nephrotoxicity need not affect the usefulness of cyclosporin A (Cy A) in liver and kidney transplant patients. Dose reductions were easy to make and did not usually lead to rejection. 'In our view. CyA remains a major advance in clinical

immunosuppression. Klintmalm. G.B.G. eta\.: Lancet I: 470 (28 Feb 1981)

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INPHARMA 21 Mar 1981

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