Who should be converted from XXXX to conventional immunosuppression in kidney transplantation, and why.

@entity1 @entity8 @entity101 @entity500 @entity1674 @entity177 @entity205 @entity1011 @entity413 @entity165
Twenty-three cadaveric renal allograft recipients with stable but compromised kidney function were electively converted from @entity205 to @entity500 one year after transplantation. Within a few weeks glomerular filtration rate (GFR) rose by 40% and serum @entity1011 fell from 171 +/- 12 (mean +/- SEM) to 129 +/- 7 mumol/L. The increase in GFR was due to an increase in effective renal plasma flow of 21%. This suggests that one year of continuous @entity205 (CsA) therapy does not result in irreversible structural @entity8 . Although antihypertensive treatment was not changed, blood pressure fell from 142 +/- 4/90 +/- 3 to 123 +/- 3/77 +/- 2 mmHg. In addition a significant drop in serum @entity165 and @entity1674 and an improvement in @entity413 tolerance were found. The beneficial effects on @entity177 , blood pressure, and metabolic indices were, however, outweighed by a high incidence of postconversion rejection in recipients of a second allograft. For these @entity1 conversion from CsA to @entity500 seems therefore contraindicated. Recipients of a first kidney allograft can be converted safely, as long-term CsA administration in these @entity1 induced a solid engraftment. The sequelae of the mode of treatment--impaired @entity177 , @entity101 , and metabolic disturbances--are reversible even after late conversion.
