Impact of mycophenolate mofetil on wound complications and lymphoceles after kidney transplantation.
OBJECTIVE
Despite improved efficacy, modern immunosuppressive agents may show unanticipated side effects. In this study we investigated the possible interactions of mycophenolate mofetil (MMF) with wound healing and lymphocele formation.


METHODS
We conducted a retrospective single-center analysis in 144 patients receiving a cyclosporine A-based immunosuppression with prednisolone and either MMF (n = 77) or azathioprine (AZA, n = 77). Endpoints were incidences of lymphocele formation and non-primary wound healing during 6 months' follow-up.


RESULTS
AZA-treated patients had more rejection episodes and consecutively more steroid pulses, both being potential risk factors for endpoints. No graft was lost in any group and graft function was comparable. AZA patients demonstrated a trend for more frequent wound infections. Fluid accumulation around the graft, however, was more frequent in the MMF group (OR = 2.6; p = 0.03). Consequently, more drainage maneuvers (17 vs. 5 interventions) and sclerotherapies (8 vs. 0 interventions) were undertaken in MMF patients. Pre-assigned risk factors for lymphoceles reported before did not differ between both cohorts; patients experiencing acute rejection episodes had even less symptomatic lymphoceles (n = 23).


CONCLUSIONS
We found a possible relationship between the administration of MMF and lymphocele formation. To avoid the hazard of reinterventions, the prolongation of hospitalization and impairment of graft function, it requires awareness and attention in patients treated with this immunosuppressant.
Lopau
Kai
K
Department of Internal Medicine I, Division of Nephrology, University of Wuerzburg, Wuerzburg, Germany. lopau_k@klinik.uni-wuerzburg.de
Syamken
Karin
K
Rubenwolf
Peter
P
Riedmiller
Hubertus
H
Wanner
Christoph
C
D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016030:Kidney Transplantation; D008210:Lymphocele / Q000139:chemically induced* / Q000453:epidemiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011183:Postoperative Complications / Q000139:chemically induced / Q000453:epidemiology / Q000276:immunology; D011239:Prednisolone / Q000008:administration & dosage; D012189:Retrospective Studies; D012307:Risk Factors; D014945:Wound Healing / Q000187:drug effects* / Q000276:immunology
D007166:Immunosuppressive Agents; D011239:Prednisolone; D009173:Mycophenolic Acid; D001379:Azathioprine