Monitoring of Mycophenolic Acid Trough Concentration in Kidney Transplant under Cyclosporine Is Beneficial in Reducing Acute Rejection within 1 Year.
10.4285/jkstn.2018.32.4.75
- Author:
Jinsoo RHU
1
;
Kyo Won LEE
;
Jae Berm PARK
;
Sung Joo KIM
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kmhyj.kim@samsung.com
- Publication Type:Original Article
- Keywords:
Kidney transplantation;
Mycophenolic acid;
Drug monitoring
- MeSH:
Cyclosporine*;
Drug Monitoring;
Humans;
Kidney Transplantation;
Kidney*;
Methylprednisolone;
Mycophenolic Acid*;
Retrospective Studies;
Risk Factors
- From:The Journal of the Korean Society for Transplantation
2018;32(4):75-83
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study was designed to analyze the clinical usefulness of mycophenolic acid trough concentration monitoring in kidney transplantation patients who were maintained with cyclosporine. METHODS: The data of patients who underwent mycophenolic acid trough concentration monitoring after their first kidney transplant between November 2006 and August 2013 and were prescribed with cyclosporine, mycophenolate, and methylprednisolone were reviewed retrospectively. Cox analysis was used to analyze the risk factors for acute rejection within 1 year post-transplantation. RESULTS: Among 90 patients, 41 (45.6%) achieved both the target levels of cyclosporine and mycophenolic acid, while three patients (3.3%) failed to achieve the target level of either cyclosporine or mycophenolic acid. Nine patients (10.0%) only achieved the mycophenolic acid target level and 37 patients (41.1%) only achieved the cyclosporine target level. While patients who achieved only the mycophenolic acid target concentration had no statistically increased risk compared to patients who achieved both target levels (hazard ratio [HR], 1.569; 95% confidence interval [CI], 0.316 to 7.778; P=0.581), patients who only achieved the cyclosporine target concentration showed an increased risk of rejection compared to the both achievement group (HR, 4.112; 95% CI, 1.583 to 10.683; P=0.004). Patients who had no achievement in the target levels showed significantly increased rejection risk compared to the patients who achieved both target levels (HR, 17.811; 95% CI, 3.072 to 103.28; P=0.001). CONCLUSIONS: Mycophenolic acid trough concentration monitoring combined with cyclosporine trough concentration monitoring is useful for avoiding acute cellular rejection if the first 1 year post-transplantation.
