Skip to main content
Log in

Effect of cyclosporin on lung diffusing capacity in renal transplant patients

  • Original Article
  • Published:
Transplant International

Abstract

A prospective lung function study pre- and postrenal transplantation was performed on 21 patients in order to evaluate whether cyclosporin decreased the lung diffusing capacity due to lung toxicity. Initial inclusion criteria were absence of respiratory symptoms and normal findings in both chest X-ray and pulmonary function tests. Participants had to be nonsmokers. We determined spirometry including lung volumes, arterial blood gases, carbon monoxide diffusing capacity by the single breath method (DLCOSB), and rate of CO uptake per unit of lung volume (KCO) before and 3, 6, and 12 months after transplantation. Immunosuppression consisted of prednisone and cyclosporin, maintaining total blood levels between 100 and 250 ng/ml. Spirometric and blood gases data remained within reference levels during the follow-up. Hemoglobin (Hb) pretransplant concentrations remained low, returning to their normal levels posttransplantation. Pretransplant DLCOSB levels were slightly decreased but fell within the therapeutic range after correction for Hb concentration, unlike the mean KCO levels which remained slightly diminished despite their correction. In post-transplant controls, the values obtained for both DLCOSB and KCO were significantly higher at the different post-transplant intervals (P<0.005) than pretransplantation but only when compared without Hb correction. No significant differences for DLCOSB were found when corrected values were compared, and an improvement in the KCO appeared to be significant at 12 months posttransplantation. Based on these findings, we feel that when serum levels are within the therapeutic range, cyclosporin fails to alter the respiratory function or the pulmonary diffusing capacity of the lung.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aronchick JM, Gefter WB (1991) Drug-induced pulmonary disease: an update. J Thorac Imaging 6: 19–29

    Google Scholar 

  2. Ballester M, Pons G, Obrador D, Carreras F, Cladellas M, Abadal ML, Amengual MJ, Bonnín O, Padró JM, Arís A, Caralps-Riera JM (1986) Ciclosporina en el trasplante cardíaco: Un tratamiento en evolución. Med Clin (Barc) 86: 600–603

    Google Scholar 

  3. Britton S, Palacios R (1982) Cyclosporin A — usefulness, risks and mechanisms of action. Immunol Rev 65: 5–22

    Google Scholar 

  4. Bush A, Gabriel R (1991) Pulmonary function in chronic renal failure: effects of dialysis and transplantation. Thorax 46: 424–428

    Google Scholar 

  5. Casán P, Sanchis J, Cladellas M, Amengual MJ, Caralps JM (1987) Diffusing lung capacity and cyclosporine in patients with heart transplants. J Heart Transplant 6: 54–56

    Google Scholar 

  6. Copeland JG, Emery RW, Levinson MM, Icenogle TB, Riley JE, McAleer MJ, Copeland JA, Dietz R (1986) Cyclosporine: an immunosuppressive panacea? J Thorac Cardiovasc Surg 91: 26–39

    Google Scholar 

  7. Cotes JE (1979) Lung function throughout life: determinants and reference values. Blackwell Scientific Publications. London, pp 225–250

    Google Scholar 

  8. Deeg HJ, Storb R, Thomas ED, Flournoy N, Kennedy MS, Banaji M, Appelbaum FR, Bensinger WI, Buckner CD, Clift RA, Doney K, Fefer A, McGuffin R, Sanders JE, Singer J, Stewart P, Sullivan KM, Witherspoon RP (1985) Cyclosporine as prophylaxis for graft-versus-host disease: a randomized study in patients undergoing marrow transplantation for acute nonlymphoblastic leukemia. Blood 65: 1325–1334

    Google Scholar 

  9. Dinakara P, Blumenthal WS, Johnston RF, Kauffman LA, Solnick PB (1970) The effect of anemia on pulmonary diffusing capacity with derivation of a correction equation. Am Rev Respir Dis 102: 965–969

    Google Scholar 

  10. Eschbach JW, Egrie JC, Downing MR, Brown JK, Adamson JW (1987) Correction of the anemia of end-stage renal disease with recombinant human erythropoietin. N Engl J Med 316: 73–78

    Google Scholar 

  11. Goldman HI, Becklake MR (1959) Respiratory function tests: normal values at median altitudes and the prediction of normal results. Am Rev Tuberc 79: 457–467

    Google Scholar 

  12. Groen HJM, Bogaard JM, Balk AH, Kho SG, Hop WC, Hilvering C (1992) Diffusion capacity in heart transplant recipients. Chest 102: 456–460

    Google Scholar 

  13. Hamilton PJ, Pearson ADJ (1986) Bone marrow transplantation and the lung. Thorax 41: 497–502

    Google Scholar 

  14. Mellemgaard K (1966) The alveolararterial oxygen difference: its size and components in normal man. Acta Physiol Scand 67: 10–20

    Google Scholar 

  15. Ogilvie CM, Forster RE, Blakemore WS, Morton JW (1957) A standardized breath-holding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide. J Clin Invest 36: 1–17

    Google Scholar 

  16. Pallardó LM, Sánchez J, García J, Moreno RF, Rochera A, Cabezudo J (1988) Low doses of cyclosporine, azathioprine and prednisone in renal transplantation: immunosuppressive efficacy and reduced nephrotoxicity. Transplant Proc 20 [Suppl 6]: 26–27

    Google Scholar 

  17. Roca J, Sanchis J, Agustí-Vidal A, Segarra F, Navajas D, Rodriguez-Roisín R, Casán P, Sans S (1986) Spirometric reference values from a Mediterranean population. Bull Eur Physiopathol Respir 22: 217–224

    Google Scholar 

  18. Roca J, Rodriguez-Roisin R, Cobo E, Burgos F, Pérez J, Clausen J (1990) Single-breath carbon monoxide diffusing capacity. Prediction equations from a Mediterranean population. Am Rev Respir Dis 141: 1026–1032

    Google Scholar 

  19. Shulman H, Striker G, Deeg HJ, Kennedy M, Storb R (1981) Nephrotoxicity of cyclosporin A after allogeneic marrow transplantation. N Engl J Med 305: 1392–1395

    Google Scholar 

  20. Taube DH, Williams DG, Hartley B, Rudge CJ (1985) Differentiation between allograft rejection and cyclosporin nephrotoxicity in renal transplant recipients. Lancet II: 171–174

    Google Scholar 

  21. Weiner RS, Bortin MM, Gale RP, Gluckman E, Kay HE, Kolb HJ, Hartz AJ, Rimm AA (1986) Interstitial pneumonitis after bone marrow transplantation. Ann Intern Med 104: 168–175

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Morales, P., Cremades, M.J., Pallardó, L. et al. Effect of cyclosporin on lung diffusing capacity in renal transplant patients. Transpl Int 8, 481–484 (1995). https://doi.org/10.1007/BF00335601

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00335601

Key words

Navigation