What is the role of leflunomide in immunosuppression after solid organ transplantation?

Updated: Jan 04, 2016
  • Author: Bethany Pellegrino, MD; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Leflunomide is a synthetic isoxazole-derivative drug that possesses both immunosuppressive and antiviral properties. It has been used off-label in the setting of resistant CMV infection or BK virus nephropathy, or in renal transplant recipients with chronic allograft dysfunction.

A prospective randomized trial is needed for its use in transplantation. Its careful usage under close monitoring may provide to eradicate BK virus or CMV infection. Its current use as a first-line agent instead of mycophenolate mofetil or sirolimus cannot be recommended.

Adverse effects such as hepatotoxicity and hemolytic anemia cannot be overlooked.

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