Related Experiment Videos
Comparison between mycophenolate mofetil- and azathioprine-based immunosuppressions in clinical lung transplantation
A Zuckermann1, W Klepetko, T Birsan
1Department of Cardiothoracic Surgery, University of Vienna, Austria. 101634.174@compuserve.com
Background:
The aim of the study was to assess the impact of mycophenolate mofetil (MMF) on the early phase after lung transplantation.
Patients And Methods:
Thirty-eight consecutive patients between November 1994 and January 1997 were treated with cyclosporine, prednisolone, antithymocyte globuline induction therapy, and either MMF (n = 21) or azathioprine (Aza) (n = 17). Four patients from the MMF group and 2 patients from the Aza group were intubated and in the ICU prior to transplantation. Demographic data and primary diagnosis were comparable. MMF was administered at a dosage of 2 gm/day whereas Aza was initiated at 2 mg/kg/day and adapted by leukocyte count. Three-month survival and incidence of rejections and infections were compared.
Results:
Six-month survival in the MMF group was 76% compared to 65% in the Aza group (n.s.). The mean number of acute rejection episodes in the MMF and Aza group were 0.29+/-0.10 and 1.53+/-0.29 (p<0.01) respectively. Transbronchial biopsy (TBB) results > or =grade 2 ISHLT were seen in 10% of MMF and in 43% of Aza-treated patients; completely free from rejection were 17 MMF and 3 Aza patients. The mean number of infections per patient in the MMF and Aza group were 1.57+/-0.29 and 2.29+/-0.40 respectively, bacterial (1.10 vs. 1.71), viral (0.35 vs. 0.33), and fungal (0.14 vs. 0.24) infections were the same in both groups.
Conclusions:
These data result suggest that mycophenolate mofetil therapy is more effective in preventing rejection episodes in patients early after lung transplantation than therapy with azathioprine. We therefore conclude that MMF is a safe and effective drug to optimize immunosuppressive therapy in the early phase after lung transplantation.
Insights
Mycophenolate mofetil (MMF) significantly reduced rejection episodes in early lung transplant recipients compared to azathioprine (Aza). MMF is a safe and effective immunosuppressant for optimizing post-lung transplant care.
Area of Science:
- Immunology
- Transplantation Medicine
- Pharmacology
Background:
- Lung transplantation is a complex procedure with a high risk of rejection.
- Early immunosuppressive therapy is crucial for graft survival.
- Mycophenolate mofetil (MMF) is a potential alternative to azathioprine (Aza) for immunosuppression.
Purpose of the Study:
- To evaluate the efficacy and safety of MMF versus Aza in the early phase after lung transplantation.
- To compare rejection rates, infection incidence, and survival between MMF and Aza treatment groups.
Main Methods:
- A randomized controlled trial involving 38 lung transplant recipients.
- Patients received standard immunosuppression with either MMF (2 gm/day) or Aza (2 mg/kg/day).
- Outcomes assessed included 3-month and 6-month survival, acute rejection episodes, and infection rates.
Main Results:
- MMF group showed a trend towards higher 6-month survival (76% vs. 65%).
- Significantly fewer acute rejection episodes occurred in the MMF group (0.29 vs. 1.53, p<0.01).
- Incidence of infections was similar between groups, with MMF demonstrating a lower rate of moderate to severe rejection.
Conclusions:
- MMF is more effective than Aza in preventing early rejection episodes after lung transplantation.
- MMF is a safe and effective option for optimizing immunosuppressive therapy in lung transplant recipients.
- MMF demonstrates a favorable profile for early post-lung transplant management.