title: Effects of mycophenolic acid on highly sensitized patients awaiting kidney transplant.
abstract: BACKGROUND
  10-30% of dialysis population awaiting renal transplantation is sensitized. Mycophenolic acid (MPA) has been shown to reduce panel reactive antibody (PRA) formation in kidney transplant recipients. Our aim was to investigate whether MPA could effectively reduce anti-HLA antibody levels and allow successful transplantation.
  
  
  METHODS
  A total of 40 highly sensitized patients were treated orally with MPA. All patients had T-cell PRA values greater than 30% (73% of patients were ≥ 75%). The PRAs, T-cell/B-cell flow cytometry crossmatch (FCXM) mean channel shift (MCS), patient/graft survival, acute rejection, and serum creatinine (SCr) were recorded.
  
  
  RESULTS
  All 40 patients showed a decrease in PRA levels. Eighteen of the 40 patients (40%) received a transplant. All four living donor recipients converted to a negative crossmatch. There was a significant decrease in FCXM MCS in all 18 transplanted patients. The mean SCr at 24 months was 1.00 ± 0.25mg/dL. Five patients (28%) experienced acute rejection. The overall one year actuarial patient and graft survival were 94% and 88%, respectively.
  
  
  CONCLUSIONS
  These findings suggest that MPA therapy is effective in reducing PRAs and increases the likelihood of successful transplantation in sensitized recipients in a potentially simpler and more cost effective manner than the current regimens employed.
authors.affiliation: Transplant Research Institute, Los Angeles, CA, United States.
authors.forename: Tariq
authors.initials: T
authors.lastname: Shah
authors.forename: Don
authors.initials: D
authors.lastname: Vu
authors.forename: Eglis
authors.initials: E
authors.lastname: Corrales-Tellez
authors.forename: James
authors.initials: J
authors.lastname: Cicciarelli
authors.forename: Ian
authors.initials: I
authors.lastname: Hutchinson
authors.forename: Robert
authors.initials: R
authors.lastname: Naraghi
authors.forename: David I
authors.initials: DI
authors.lastname: Min
mesh_terms: D000208:Acute Disease; D000906:Antibodies / Q000097:blood; D000917:Antibody Formation / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000209:etiology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects; D006680:HLA Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007114:Immunization; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control*; D006435:Renal Dialysis; D014180:Transplantation; D014850:Waiting Lists
chemical_list: D000906:Antibodies; D006680:HLA Antigens; D003404:Creatinine; D009173:Mycophenolic Acid