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Correlation between Limited Sampling Strategy for the Estimation of Mycophenolic Acid Area Under the Time Concentration Curve with Incidence of Rejection and Opportunistic Infections in Post Renal Transplant Patients

Limesh M , Limesh M.* , Atul Desai* , Renuka S.*

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Urology, Nephrology and Andrology International 1(1):p 5-14, January - June 2016. | DOI:

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Abstract

 Mycophenolate mofetil (MMF) has become the single most used immunosuppressant in solidorgan transplantation. Hence this study was done to assess Mycophenolate Mofetil dosing and MPA levels with incidence of acute rejection and opportunistic infections in early post renal transplant period .Forty four consecutive early post transplant patients were randomized 1: 1 to receive concentration controlled (CC) {n=22} or fixed dose (FD){n=22}of mycophenolate mofetil. In CC group 13 patients (60%) were below therapeutic range. 9(40%) were in the therapeutic range and no patients were above the therapeutic range. In FD group 7(30%) patients were below the therapeutic range and 14 (64%) patients were in the therapeutic range. Acute rejection in first 6 months post transplant in CC group was 18% and in FD group was 14% (p = 0.5). All rejections were seen within first 3 months post transplant. The overall cumulative incidence of infection in CC group was 24% compared to 7.5% in FD group which reached statistical significance (p<0.01) in particular at 3 months post transplant. This study has demonstrates that MMF dose individualization with therapeutic drug monitoring is not an effective method in renal transplant patients to prevent the complications in the post-transplant period such as rejection and infection. 


Keywords: MPA Levels; Post Transplant; Infection; Rejection.

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