Open AccessReasons for dose reduction of mycophenolate mofetil during the first year after renal transplantation and its impact on graft outcome
Author(s) -
Vanhove Thomas,
Kuypers Dirk,
Claes Kathleen J.,
Evenepoel Pieter,
Meijers Björn,
Naesens Maarten,
Vanrenterghem Yves,
Cornelis Tom,
Bammens Bert
Publication year - 2013
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12133
Subject(s) - medicine , mycophenolic acid , retrospective cohort study , transplantation , single center , mycophenolate , surgery , immunosuppression , urology , gastroenterology
Summary Mycophenolate mofetil ( MMF ) decreases the risk of acute rejection and is associated with improved graft survival in renal transplant recipients. However, MMF ‐related side effects often necessitate dose reduction, which may expose patients to a higher risk of acute rejection and graft loss. This study's aim was to examine the reasons for MMF dose reduction during the first post‐transplant year and its impact on acute rejection, overall and death‐censored graft loss. Methods: Single‐center retrospective analysis of 749 renal transplant recipients treated with MMF in their initial maintenance immunosuppressive protocol. Results: In 365 patients (48.7%) a total of 530 MMF dose reductions were done. Reasons for reduction were hematologic toxicity (46.5%), infection (16.1%), gastrointestinal side effects (12.3%), malignancy (2.1%), study protocol (14.6%), and unknown (13.5%). MMF dose reduction as such was not an independent predictor of acute rejection or graft survival, although reductions in ≥50% of initial dose were significantly associated with acute rejection. Conclusions: In this retrospective cohort, by far the most important reason for MMF dose reduction during the first post‐transplantation year was hematologic. MMF dose reductions in ≥50% increased the risk of acute rejection but did not compromise graft survival.