Mycophenolate mofetil for prevention and treatment of rejection of the graft and its safety in renal transplant recipients

Abstract

Objectives To investigate the efficacy and safety of mycophenolate mofetil(MMF)for prevention and treatment of rejection in renal transplants.Methods A totaI of 124 renal transplant recipiAzathioprine 50 mg/d(n=76).All of the patients generally administered ATG,CsA and Pred as basic immunosuppression.The morbidity of acute rejection(AR),corticosteroid-resistant rejection(CRR)and complication in the patients of the two groups 2 months after transplantation were observed.Results There was no significant differenee in morbidity,3-month-graft loss between two groups.Morbidity of acute rejection and CRR was 31.2%and 6.2%respectively in MMF group,significantly lower than in Aza group(both P＜0.05).The efficacy of MMF 3.0 g/d to treat CRR was similar to that of OKT3.The side effects related to MMF and Aza included vomiting,diarrhea,leukocytopenia,panhematopenia,infection and medicamentous liver lesion,and its morbidity in MMF group and Aza group was 8.3%vs 2.6%(P＞0.05),62.5% vs 39.5%(P＜0.05),31.2%vs 13.2%(P＜0.05),6.3%vs 0(P＜0.001),50.0%vs 46.0%(P＞0.05),4.2%、vs 11.8(P＞0.05),respectively.58.3% of the patients experienced at least one adverse events and 25.0% of the patients had to reduce or withdraw MMF in MMF group compared with 19.7% and 9.2% in Aza group(P＜0.001 and 0.05)respectively.Conclusions MMF could significantly decrease the incidence of early AR and CRR respectively.Large dose of MMF (3.0 g/d)to treat CRR had a good efficacy.The side effects of MMF were more severe than those of Aza and one fourth was compelled to decrease or withdraw MMF in MMF group. Key words: Kidney transplantation; Immunosuppressive agents; Graft rejection