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Effect of Mycophenolate Mofetil (MMF) on Progression of Chronic Allograft Dysfunction


Mihovilović, Karlo; Maksimović, Bojana; Kocman, Branislav , Vidas, Željko; Galesić Ljubanović, Danica; Knotek, Mladen
Effect of Mycophenolate Mofetil (MMF) on Progression of Chronic Allograft Dysfunction // American Society of Nephrology Kidney Week
San Diego, SAD, 2012. (poster, međunarodna recenzija, sažetak, znanstveni)


Naslov
Effect of Mycophenolate Mofetil (MMF) on Progression of Chronic Allograft Dysfunction

Autori
Mihovilović, Karlo ; Maksimović, Bojana ; Kocman, Branislav , Vidas, Željko ; Galesić Ljubanović, Danica ; Knotek, Mladen

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
American Society of Nephrology Kidney Week

Mjesto i datum
San Diego, SAD, 30.10-4.11. 2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Mycophenolate Mofetil; Chronic Allograft Dysfunction

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti



POVEZANOST RADA


Projekt / tema
198-0000000-3355 - Značaj morfoloških čimbenika u dijagnostici, terapiji i prognozi FSGS (Danica Galešić-Ljubanović, )

Ustanove
Klinička bolnica "Dubrava"