Lower incidence of chronic allograft nephropathy at 1 year post-transplantation in patients treated with mycophenolate mofetil.
Chronic allograft nephropathy (CAN) is the main cause of graft failure after the first year of transplantation. This prospective, centrally randomized, open-label study was conducted to examine the possibility that mycophenolate mofetil (MMF) can prevent the emergence of CAN. The incidence of biopsy-proven CAN at 1 year was compared between two cyclosporine-based regimens comprising either mycophenolate mofetil (MMF) or azathioprine (AZA). The AZA group (n = 34) and the MMF group (n = 37) were balanced for all baseline characteristics of donors and recipients, the pre-existence of renal lesions on donor biopsy, the incidence of delayed graft function and acute rejection. Based on an intent-to-treat analysis, the number of patients with CAN at 1 year post-transplantation was significantly reduced in the MMF group (17/37-46%) compared with the AZA group (24/34-71%) (p = 0.03). When observed data were considered, 56/71 (78.8%) patients had a 1-year biopsy, and the number of patients with CAN was significantly lowered in the MMF group (9/29-31%) compared with the AZA group (17/27-63%) (p = 0.01). These results suggest a beneficial effect of MMF on the incidence of CAN at 1 year post-transplantation.
Department of Nephrology-Renal Transplantation, CHU Pellegrin, Bordeaux, France. pierre.merville@chu-bordeaux.fr
Pierre
P
Merville
Frank
F
Bergé
Colette
C
Deminière
Delphine
D
Morel
Guillaume
G
Chong
Dominique
D
Durand
Lionel
L
Rostaing
Georges
G
Mourad
Luc
L
Potaux
D000293:Adolescent; D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D002908:Chronic Disease; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000635:transmission; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D014184:Transplantation, Homologous / Q000473:pathology*
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D001379:Azathioprine