Effect of Mycophenolate Mofetil (MMF) on Progression of Chronic Allograft Dysfunction (CROSBI ID 606701)
Prilog sa skupa u zborniku | sažetak izlaganja sa skupa | međunarodna recenzija
Podaci o odgovornosti
Mihovilović, Karlo ; Maksimović, Bojana ; Kocman, Branislav , Vidas, Željko ; Galesić Ljubanović, Danica ; Knotek, Mladen
engleski
Effect of Mycophenolate Mofetil (MMF) on Progression of Chronic Allograft Dysfunction
Background: Main histological changes that determine chronic transplant dysfunction are interstitial fibrosis and tubular atrophy (IF/TA). Evidence from animal models suggests that MMF may exert a positive effect on renal damage by direct antifibrotic properties due to antiproliferative action on both immune and nonimmune cells. The aim of our study was to investigate role of MMF dose on progression of chronic allograft dysfunction. Methods: A cohort of 80 patients included patients with kidney, kidney-pancreas and kidney-liver transplantation.Protocol kidney biopsies were scored according to the Banff 07 classification. Interstitial fibrosis (ci) and tubular atrophy (ct) progression was determined by calculating Δci and Δct after subtracting 0 biopsy scores from 1 year chronic scores. Estimated GFR (eGFR) was calculated using Cockroft Gault formula. MMF exposure was determined as average MMF dose over 1 year post transplant, calculated from dose at month 1, 3, 6 and 12. Univariate and multiple regression analyses were done to test relationship between independent variables and eGFR, Δci and Δct. Results: Average MMF dose during 1 year posttransplant was 2151mg ± 610 (range 1062.5 – 4000). eGFR at 1 year post transplant positively correlated with average MMF dose (p=0.046) while donor and recipient age(p<0.05) negatively correlated with eGFR. Allograft function was also negatively correlated with Δci and Δct (p<0.05). In multivariate analysis average MMF dose remained significant for eGFR at 1 year post transplant (b=0.27±0.1, p=0.01). In univariate analyses both Δci and Δct significantly negatively correlated with average MMF dose (p <0.01). In a multiple regression analyses Δci (b=-0, 36 ± 0.11, p<0.01) and Δct (b=-0, 40 ± 0, 11, p<0.01) were independently only associated with MMF dose. Conclusions: Higher MMF dose over 1 year is associated with better renal function and slower progression of IF/TA.
Mycophenolate Mofetil; Chronic Allograft Dysfunction
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Podaci o prilogu
2012.
objavljeno
Podaci o matičnoj publikaciji
Podaci o skupu
American Society of Nephrology Kidney Week
poster
30.10.2012-04.11.2012
San Diego (CA), Sjedinjene Američke Države