Experience with the application of leflunomide in rescuing therapy of BK virus nephropathy after renal transplantation in the case of ineffective treatment with reduction of immunosuppressant:report of 4 cases
10.3969/j.issn.1674-7445.2016.01.009
- VernacularTitle:来氟米特用于抢救性治疗减免免疫抑制剂无效的肾移植术后 BK 病毒性肾病的体会：附4例报告
- Author:
Yu FAN
1
;
Jigang LI
;
Yeyong QIAN
;
Bingyi SHI
;
Junjie XIE
Author Information
1. 解放军第 309 医院泌尿二科
- Keywords:
Leflunomide;
Renal transplantation;
BK virus nephropathy;
Immunosuppressant
- From:
Organ Transplantation
2016;(1):48-52,71
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical application experience of leflunomide in rescuing therapy of BK virus nephropathy (BKVN ) after renal transplantation in the case of ineffective treatment with reduction of immunosuppressant.Methods Four recipients with BKVN after renal transplantation were diagnosed at 1 35 th-737 th day after operation,with the pathological staging as following:2 cases in stage A1 ,1 case in stage B1 and 1 case in stage B2.For all recipients, leflunomide was used for rescuing therapy due to ineffective treatment with reduction of immunosuppressant for 0.5-3.0 months.Initially,50 mg/d of leflunomide was given continuously for 3 days,so as to reach therapeutic serum concentration,and then 20 mg/d of leflunomide was given for maintaining.The efficacy and safety were observed.Results After a follow-up for an average of 6 months (5-7 months),3 recipients with development of BKVN were controlled effectively,1 recipient (stage B2)with ineffective treatment.No obvious adverse reactions occurred during medication.Conclusions It is possible to slow down the development of BKVN and reduce the incidence of renal allograft loss by using leflunomide to conduct rescuing therapy of BKVN after renal transplantation in the case of ineffective treatment with reduction of immunosuppressant.Better effect can be achieved if early detection and diagnosis of BKVN are conducted as well as effective measures are taken timely in the early pathological stage.
