Heart Transplant Research Today is a free monthly online journal that collates and summarizes the latest research about Heart Transplant, including details on risks, prognosis, procedure, surgery, organ donation.

Heart transplant recipient clinical profile improvement following mycophenolate mofetil late incorporation into the treatment schedule.

Manito N, Kaplinsky EJ, Roca J, Castells E, Saura E, Gomez-Hospital JA, Esplugas E

Heart Transplant Unit, Bellvitge Hospital, University of Barcelona, Barcelona, Spain. nml@csub.scs.es

Mycophenolate mofetil (MMF) has a better clinical profile than azathioprine in heart transplantation (HT). Forty-five recipients (aged 53 +/- 9 yr) were retrospectively evaluated (first year of follow-up) post-MMF introduction since its advent in 1997 (mean daily dose: 1.97 +/- 0.2 g). MMF was used (mean post-HT time: 40 +/- 27 months) for: (i) renal insufficiency attenuation (group 1 = 20); (ii) steroid reduction because of osteoporosis (group 2 = 12); (iii) treatment of persistent cellular rejection (group 3 = 7) and vascular graft disease (VGD) (group 4 = 6). Mean changes (groups 1-2) were: creatinine 172 +/- 59, 158 +/- 51, 153 +/- 57 mumol/L (at baseline, 6 and 12 months, respectively; p < 0.001). Cyclosporine daily dose: 219 +/- 37, 166 +/- 46, 176 +/- 98 mg, respectively (p < 0.001). Cyclosporine blood concentration: 151 +/- 40, 103 +/- 41, 83 +/- 34 ng/mL, respectively (p < 0.004). Prednisone daily dose: 8.3 +/- 2, 5.2 +/- 1, 4.1 +/- 1 mg, respectively (p < 0.001). Cellular rejection (group 3) was successfully treated (86%) but the outcome of VGD did not improve after the switch (group 4). Our limited experience (with caution) confirms the reported benefits of MMF particularly attenuating renal insufficiency.

Published 9 May 2005 in Clin Transplant, 19(3): 304-8.
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