WITHDRAWAL OF MYCOPHENOLATE MOFETIL IN STABLE RENAL TRANSPLANT PATIENTS

Abstract

440 Mycophenolate mofetil (MMF) has been shown to decrease episodes of acute rejection in renal transplant recipients during the first year. The utility of MMF after one year is less clear. We looked at withdrawal of MMF in stable renal transplant recipients after one year. Methods: 70 stable renal transplant patients who had not had an episode of acute rejection were screened. All patients were on Neoral, MMF (initially 1 gm bid) and Prednisone. Patients were assigned to be taken off MMF and to remain on dual therapy (35) or to remain on triple therapy (35). CsA 12 hour trough concentrations were maintained above 150 ng/ml and the Prednisone dose above 5mg/day. Results: A total of 35 patients were taken off MMF at 20.7 ± 9.2(range 5-56) months post tx, and followed up for 7.6 ± 5.3 (range 1-26) months post withdrawal. Of these 35 patients one patient suffered a rejection episode (borderline) 5 month after MMF withdrawal. As displayed in the table no differences in renal function as estimated by the calculated creatinine clearance (CrCl) and serum creatinine (Scr) were observed after as compared to before MMF withdrawal. There were also no changes in incidence of proteinuria, hyperlipidemia or hematological abnormalities. A general linear model for repeated measures did not show any significant differences over time of the above parameters in the MMF withdrawal group as compared to the control group over the total follow up period (28.3 ± 8.7 and 29.3 ± 7.2 months respectively). Conclusions: Our preliminary data would suggest that it may be safe to withdraw MMF at one year in stable renal transplant patients who had no previous acute rejection.Table