Mycophenolate mofetil in prevention of acute renal allograft rejection and treatment of chronic allograft nephropathy

Mycophenolate mofetil (MMF) is a potent immunosuppressant which can reduce an incidence of acute rejection in renal allograft recipients and slow progression of chronic allograft nephropathy (CAN). The aim of our study was to evaluate the effectiveness of MMF in acute transplant rejection and in treatment of CAN and to estimate the adverse effects. A group of renal transplant recipients (n = 47) receiving MMF (1,0-2,0 g/day) with cyclosporine A (CsA) and steroids during 6 months after transplantation was compared with a group (n = 47) taking triple immunosuppression protocol including azathioprine (Aza). Separate group of patients (n = 9) received MMF for treatment of CAN. Acute rejection rate was statistically lower in MMF group comparing with Aza group - 32,6% versus 57,45%, respectively, p = 0,022. In patients receiving MMF mean arterial pressure 12 months after transplantation was lower comparing with patients taking Aza - systolic pressure was 135,00 ± 2,57 mm Hg in MMF group versus 145,90 ± 2,00 mm Hg in Aza group, p = 0,001; diastolic pressure - 84,81 ± 1,95 mm Hg versus 91,03 ± 1,63 mm Hg, respectively, p = 0,017. Incidence of adverse effects was similar in both groups. Total rate of infection episodes (including urinary tract infections) was lower in MMF group than in Aza group - 72,3% versus 93,6%, respectively, p = 0,012. Using of MMF in renal transplant recipients with CAN decreased serum creatinine level and proteinuria. In 7 of 9 patients MMF improved or stabilized allograft function. To our mind, MMF is effective and safe drug to prevent of renal allograft acute rejection and to treat CAN.

мофетила микофенолат, трансплантация почки, острое отторжение, хроническая трансплантационная нефропатия, профилактика, лечение, побочные эффекты

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