Mycophenolate Mofetil Initiation in Renal Transplant Patients at Different Times Posttransplantation: the TranCept Switch Study

Mycophenolate Mofetil Initiation in Renal Transplant Patients at Different Times Posttransplantation: the TranCept Switch Study

Author Meier-Kriesche, Herwig-Ulf Google Scholar
Merville, Pierre Google Scholar
Tedesco-Silva, Helio Autor UNIFESP Google Scholar
Heemann, Uwe Google Scholar
Kes, Petar Google Scholar
Haller, Hermann Google Scholar
Rostaing, Lionel Google Scholar
Gafner, Nesrin Google Scholar
Bernasconi, Corrado Google Scholar
Institution Univ Florida
Hop Pellegrin
Universidade Federal de São Paulo (UNIFESP)
Tech Univ Munich
Univ Hosp Ctr Zagreb
Hannover Med Sch
CHU Rangueil
Nesrin Gafner Consulting
F Hoffmann La Roche & Co Ltd
Abstract Background. Despite evidence of favorable long-term effects of mycophenolate mofetil (MMF) in renal transplantation, its introduction at different times posttransplant has not been studied in large cohorts.Methods. Single-organ renal allograft recipients (n=2217) who had MMF introduced 6 months to more than 20 years posttransplantation for various reasons were included in TranCept Switch, a multicenter, noninterventional, observational 4-year study. Changes in renal function before and after the introduction of MMF were analyzed.Results. MMF was introduced because of renal function decline in 43% of patients and poor tolerability with previous treatment in 23% of patients. the change in slope of the calculated glomerular filtration rate (modification of diet in renal diseases formula) regression line before and after MMF initiation was +2.01 mL/min per year (P<0.001) on average. the greatest benefit was noted in patients who received MMF because of renal function decline and in whom calcineurin inhibitor treatment was subsequently reduced or withdrawn (+3.09 mL/min per year). Time from transplantation to MMF introduction influenced the glomerular filtration rate at MMF initiation (slow progressive deterioration) but not the direction of the slope change, which was positive even for late introduction.Conclusion. MMF introduction may be associated with improvement or stabilization of renal function even several years after transplantation.
Keywords Mycophenolate mofetil
Calcineurin inhibitor withdrawal
Glomerular filtration rate
Nephrotoxicity
Language English
Sponsor F. Hoffmann-La Roche Ltd.
Basel, Switzerland
Bristol Meyer Squibb
Gilead
Life cycle Pharma
Novartis
Pfizer
Astellas
Forest
Jansen-Cilag
Date 2011-05-15
Published in Transplantation. Philadelphia: Lippincott Williams & Wilkins, v. 91, n. 9, p. 984-990, 2011.
ISSN 0041-1337 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 984-990
Origin http://dx.doi.org/10.1097/TP.0b013e3182130966
Access rights Closed access
Type Article
Web of Science ID WOS:000289773000011
URI http://repositorio.unifesp.br/handle/11600/33707

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