[Mycophenolic acid concentration profiles may select recipients with high-risk of acute rejection in renal transplant recipients].
The aim of the study was to assess relationship between the pharmacokinetics of mycophenolic acid (MPA) and the risk of developing acute rejection within 6 months after renal transplantation.


METHODS
MPA concentrations were measured using validated HPLC. Venous blood samples for assay of MPA plasma concentrations were evaluated before (trough level; C) and 40 minutes, 1, 2 and 4 hours after mycophenolate mofetil (MMF) oral administration. The study included adult kidney cadaveric graft recipients: 26 patients treated with CsA, MMF and prednisone. MPA AUC was determined using the linear trapezoidal rule. Statistical significance was assessed using ANOVA Statistica.


RESULTS
A total of 13 patients experienced biopsy proven rejection. Patients with acute rejection had lower GFR, lower serum albumin and were younger. There was statistically significant difference for MPA AUC(0-4), C40, C(max) between patients with acute rejection and patients with uneventful outcomes: mean MPA AUC(0-4): 11,4 +/- 7,23 microg x h/ml versus 34,0 26,8 microgxh/ml (p 0,01). Recipients with MPA AUC(0-4) <20 g x h/ml had a greater risk of acute rejection.


CONCLUSIONS
MPA AUC(0-4) was a useful predictor of outcome in renal recipients within first 6 months after renal transplantation.
Kuriata-Kordek
Magdalena
M
Akademia Medyczna we Wrocławiu, Katedra i Klinika Nefrologii i Medycyny Transplantacyjnej. madzia-k-k@wp.pl
Boratyńska
Maria
M
Urbaniak
Joanna
J
Woźniak
Mieczysław
M
Patrzałek
Dariusz
D
Szyber
Piotr
P
Klinger
Marian
M
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D019540:Area Under Curve; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006084:Graft Rejection / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000493:pharmacokinetics; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood* / Q000493:pharmacokinetics; D051437:Renal Insufficiency / Q000276:immunology
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid