Correlation between Mycophenolate Dosage and Occurrence of Adverse effects in Renal Transplant Patients

Abstract

Background Mycophenolate mofetil (MMF) is effective in improvement of graft survival and prevention of acute rejection after kidney transplantation. It has been shown in a study that decreasing MMF dose due to infection does not increase the incidence of rejection or graft failure. However, another study showed dose reduction of MMF had increased acute rejection and poorer long-term graft survival. As there is contradictory evidence regarding the optimal dose of MMF, we studied the correlation between MMF dose and occurrence of adverse effects (infection/rejection) in renal transplant patients. Method This is a retrospective, single centre study on patients who received a renal transplant from 1st January 2011 to 31st December 2013, in our unit. All transplant recipients who was commenced on MMF as part of triple immunosuppression on the first day post-transplant were included and followed up for three years. Information was obtained from hospital electronic records. MMF dosage immediately following transplant, at three, six, 12 and 36 months post transplant were recorded and average dose was calculated. Infection was determined if positive cultures, high inflammatory markers or positive viral loads. Rejection was analysed if biopsy proven. Results There were 165 renal transplants. 74 patients had completed 3-year follow up. Table 1 shows the results.Conclusion A link between dosage of MMF and infection/rejection rates has not been observed in this study. Further data will need to be analyzed for a conclusive result.