Abstract
The aim of this study was to evaluate the influence on mycophenolic acid (MPA) pharmacokinetics after replacing tacrolimus (Tac) with sirolimus (SRL) 2–3 months after simultaneous pancreas/kidney transplantation. No previous study has investigated this pharmacokinetic interaction in this cohort of patients. The MPA dose-normalized area under the concentration-time curve from 0 to 12 h (AUC 0–12h ) and the apparent clearance of MPA (Cl/ F ) were compared intra-individually ( n =12) before and after conversion to SRL. A significant increase ( p <0.05) in the dose-normalized AUC 0–12 h (0.0551±0.0256 vs 0.0688 ± 0.0284 h mg/L/mg of MMF (arithmetical mean±SD)) and a significant decrease ( p <0.05) of Cl/ F (23.0±14.2 vs 17.2±7.7 (arithmetical mean±SD)) were observed intra-individually after conversion to SRL. To explain these results, the influences of corticosteroid withdrawal, the delay after transplantation and the Tac withdrawal followed by the introduction of SRL on MPA exposure are discussed.
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