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Volume 350:1254-1256 March 18, 2004 Number 12
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Chronic Allograft Nephropathy

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 by Nankivell, B. J.
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To the Editor: Nankivell et al. (Dec. 11 issue)1 report that serial renal biopsies in recipients of kidney and pancreas transplants who were given calcineurin inhibitors showed that chronic rejection was rare but that, over time, these drugs led to irreversible lesions. The authors conclude that calcineurin inhibitors are unsuitable for long-term immunosuppression.

The authors should be congratulated for their informative contribution, but their conclusions may be challenged. With a regimen based on calcineurin inhibitors, Nankivell et al. report that the survival rate for kidney grafts, with data censored for patients who died, was 95.2 percent at 10 years. I . . . [Full Text of this Article]




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