Mycophenolate Mofetil in Pediatric Renal Transplantation Without Induction Therapy: Results After 12 Months of Treatment1,2

Abstract

The combination of MMF, CyA, and Pred reduced ARE in pediatric RTx without incurring major side effects.

Steroid withdrawal in pediatric and adult renal transplant recipients

“…In two prospective multicenter studies in pediatric renal transplant recipients, the incidence of acute rejection episodes in patients on MMF in conjunction with CsA and steroids was approximately 50% lower than in historical controls on AZA [21,22]. In one prospective, open-labeled, multicenter study the incidence of acute rejection episodes during the first 6 months following renal transplantation was 27.6% in the MMF group and 59.3% in the historical control cohort receiving AZA [21].…”

“…In one prospective, open-labeled, multicenter study the incidence of acute rejection episodes during the first 6 months following renal transplantation was 27.6% in the MMF group and 59.3% in the historical control cohort receiving AZA [21]. Whereas patients in the MMF group exhibited only mild or moderate signs of rejection, 36% of biopsy proven acute rejection episodes in the AZA group were severe or hyperacute.…”

Consensus Report on Therapeutic Drug Monitoring of Mycophenolic Acid in Solid Organ Transplantation

“…This popularity of mycophenolate reflects its proven efficacy in reducing risk for acute renal rejection and its safety and tolerability profile. The incidence of acute rejection is markedly lower, ranging from 15 to 35%, in patients who received MMF compared with those who received either azathioprine or no antimetabolite in combination with a CNI and corticosteroids (85)(86)(87)(88)(89). MMF has also been found to improve 5-year outcome in pediatric renal transplant recipients and prolong half-life of the graft (90).…”

Pediatric renal transplantation with mycophenolate mofetil-based immunosuppression without induction: results after three years1,2

“…MMF in combination with cyclosporine (CsA) and corticosteroids has been shown to decrease the incidence of ARE in adult and pediatric transplant recipients during the first 6 to 12 months after RTX by about 50% compared with placebo or azathioprine (AZA) (7)(8)(9)(10)(11)(12). Although acute rejection rates were reduced, the 1-year analysis of patient and graft survival showed no significant differences between MMF and AZA (10).…”