title: Clinical mycophenolic acid monitoring in liver transplant recipients.
abstract: In liver transplantation, the efficacy of mycophenolate mofetil (MMF) has been confirmed in clinical trials and studies. However, therapeutic drug monitoring for mycophenolic acid (MPA) has not been fully accepted in liver transplantation as no long-term prospective study of concentration controlled vs fixed-dose prescribing of MMF has been done. This review addressed MPA measurement, pharmacokinetic variability and reasons of this variation, exposure related to acute rejection and MMF-associated side effects in liver transplant recipients. Limited sampling strategies to predict MPA area under the concentration-time curve have also been described, and the value of clinical use needs to be investigated in future. The published data suggested that a fixed-dosage MMF regimen might not be suitable and monitoring of MPA exposure seems helpful in various clinical settings of liver transplantation.
authors.affiliation: Hao Chen, Center of Organ Transplantation and Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200240, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Hao Chen, Center of Organ Transplantation and Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200240, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Chen
mesh_terms: D016903:Drug Monitoring; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*; D016031:Liver Transplantation / Q000009:adverse effects; D008954:Models, Biological; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: Liver transplantation; Mycophenolate mofetil; Mycophenolic acid; Pharmacokinetics; Therapeutic drug monitoring