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Decreased Total Interstitial Inflammation with Higher Mycophenolate Mofetil Dose after Kidney Transplantation


Mihovilovic, Karlo; Senjug, Petar; Maksimovic, Bojana; Galessic Ljubanovic, Danica; Zunec, Renata; Palfi, Biserka; Knotek, Mladen
Decreased Total Interstitial Inflammation with Higher Mycophenolate Mofetil Dose after Kidney Transplantation // J Am Soc Nephrol 24: 2013
USA, Atlanta, 2014. (poster, međunarodna recenzija, sažetak, znanstveni)


Naslov
Decreased Total Interstitial Inflammation with Higher Mycophenolate Mofetil Dose after Kidney Transplantation
(Decreased Total Interstitial Infl ammation with Higher Mycophenolate Mofetil Dose after Kidney Transplantation)

Autori
Mihovilovic, Karlo ; Senjug, Petar ; Maksimovic, Bojana ; Galessic Ljubanovic, Danica ; Zunec, Renata ; Palfi, Biserka ; Knotek, Mladen

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

Izvornik
J Am Soc Nephrol 24: 2013 / - , 2014

Skup
ASN 2013 Kidney Week

Mjesto i datum
USA, Atlanta, 05-10.11.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Mycophenolate mofetil; Kidney transplantation; Total Interstitial Inflammation
(Mycophenolate Mofetil; Kidney Transplantation; Total Interstitial Inflammation)

Sažetak
Background: We have recently found that higher average mycophenolate mofetil (MMF) dose during fi rst posttransplant year was associated with decreased progression of interstitial fi brosis and tubular atrophy during fi rst posttransplant year in kidney transplant recipients. In the present study we sought to evaluate effect of MMF dose on total interstitial infl ammationscore at one year.Methods: This is a single-center retrospective study in which 67 kidney, or kidneypancreas recipients with 12 month protocol biopsy were included.Patients with recurrence of glomerulonephritis and with BKV nephropathy were excluded from the analysis. Immunosuppression consisted of anti-IL2 induction, with tacrolimus or cyclosporine and MMF ± steroid maintenance.During 2007-2010 MMF was dosed in our center according to C0 monitoring, which led to its dose dispersion (1000-4000 mg/day). Total interstitial infl ammation (ti score) and interstitial fi brosis (ci score) were determined according to Banff classifi cation. Creatinine clearence (eClcr) was estimated by the Cockroft-Gault formula. Results: Recipients, were 44.75 ± 12.34 y/o, 65 percent of them were male. There were 20 living donor transplantations. At 12 months postttransplant mean MMF dose was 2205 ± 627 mg/d, eClcr 62.1 ± 16.4 ml/min, ci score 0.87 ± 0.78 and ti score 0.72 ± 0.88. Average MMF dose during fi rst posttransplant year was 2238 ± 571 mg. There was positive correlation between 12 months ci and ti score (r=0.716, p<0.001). Both, ci (r=-0.401, p<0.001) and ti score (r=-0.319, p=0.01) were negatively correlated with MMF dose at 12 months.Similarly, there was a negative correlation of average MMF dose over fi rst posttransplant year with ci (r=-0.337, p<0.01) and ti score (r=-0.250, p<0.05). MPA concentration (C0) at either 12 months, or 1 year average, as well as respective tacrolimus concentrations did not correlate with 12 month ci or ct scores. Conclusions: Higher MMF dose during fi rst year posttransplant may be associated with better kidney allograft histology and less infl ammation.

Izvorni jezik
Engleski



POVEZANOST RADA


Projekt / tema
044-0000000-3356 - Imunološki nadzor u bolesnika s transplantiranim solidnim organom (Mladen Knotek, )

Ustanove
Medicinski fakultet, Zagreb