Mycophenolate Mofetil Dose Reduction in Renal Transplant Recipients: A 5-Year Follow-up Study
Mycophenolate Mofetil Dose Reduction in Renal Transplant Recipients: A 5-Year Follow-up Study
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DOI：
10.1016/j.transproceed.2009.07.036
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发表时间：
2009-09-01
影响因子：
0.9
通讯作者：
Amjadi, M.
中科院分区：
文献类型：
--
作者：
Khosroshahi, H. T.;Shoja, M. M.;Amjadi, M.
Objective.霉酚酸酯（MMF）是一种广泛用于肾移植的免疫抑制剂，与几种剂量依赖性血液学和胃肠道副作用相关，可能需要减少剂量甚至停药。本研究的目的是比较肾移植受者之间的移植肾功能和急性排斥反应的发生谁是至少5年的两种方案的霉酚酸酯。对55例肾移植受者的前瞻性队列进行了随访，以了解移植物功能恶化、急性排斥反应的证据和移植物存活情况。22例患者（40%）由于感知到的副作用或经济原因（第1组），将MMF剂量降至1.35 - 0.23 g/d。这种变化的平均时间是肾移植后4.2 +/- 2.1个月。其余患者（第2组，n = 33）继续接受MMF（2 g/d）治疗。所有患者在移植后至少随访5年。肾功能检查（血尿素和血清肌酐）每月测量2年，然后每2个月。使用SPSS 11.0（Student t检验）进行统计分析。平均血清肌酐值分别为1.32 +/- 0.14和1.38 +/- 0.21 mg/dL（P > 0.05）。第2组有2例移植物丢失和1例患者丢失。第1组患者中也有2例移植物丢失。我们的研究表明，MMF剂量减少与5年时急性肾移植排斥反应或移植肾功能受损的风险增加无关。
Objective. Mycophenolate mofetil (MMF), an immunosuppressant that is widely used in renal transplantation, is associated with several dose-dependent hematologic and gastrointestinal side effects that may require dose reduction or even discontinuation. The aim of this study was to compare renal allograft function and acute rejection episodes among kidney allograft recipients who were on 2 regimens of MMF for at least 5 years.Materials and Methods. This prospective cohort of 55 kidney allograft recipients was followed for deterioration of allograft function, evidence of acute rejection, and allograft survival. Twenty-two patients (40%) underwent MMF dose reduction to 1.35 to 0.23 g/d due to perceived side effects or economic reasons (group 1). The mean time for this change was 4.2 +/- 2.1 months after kidney transplantation. The remaining patients (group 2, n = 33) were continued on MMF (2 g/d). All patients were followed for at least 5 years after transplantation. Renal function tests (blood urea and serum creatinine) were measured monthly for 2 years and then every 2 months. Statistical analysis was performed using SPSS 11.0 (Student t test). P .05); mean serum creatinine values were 1.32 +/- 0.14 and 1.38 +/- 0.21 mg/dL, respectively (P > .05). There were 2 graft losses and 1 patient loss in group 2. There were also 2 graft losses among group 1 patients.Conclusion. Our study showed that MMF dose reduction was not associated with an increased risk of acute renal allograft rejection or impaired allograft function at 5 years.