Related Experiment Video
Updated: Oct 15, 2026
Mouse Kidney Transplantation: Models of Allograft Rejection
Published on: October 11, 2014
Mycophenolate mofetil reduces late renal allograft loss independent of acute rejection
A O Ojo1, H U Meier-Kriesche, J A Hanson
1Department of Medicine, The University of Michigan, Ann Arbor 48109, USA.
Background:
Mycophenolate Mofetil (MMF) has been shown to significantly decrease the number of acute rejection episodes in renal transplant recipients during the 1st year. A beneficial effect of MMF on long-term graft survival has been more difficult to demonstrate. This beneficial effect has not been detected, despite the impact of acute rejection on the development of chronic allograft nephropathy and experimental evidence that MMF may have a salutary effect on chronic allograft nephropathy independent of that of rejection.
Methods:
Data on 66,774 renal transplant recipients from the U.S. renal transplant scientific registry were analyzed. Patients who received a solitary renal transplant between October 1, 1988 and June 30, 1997 were studied. The Cox proportional hazard regression was used to estimate relevant risk factors. Kaplan-Meier analysis was performed for censored graft survival.
Results:
MMF decreased the relative risk for development of chronic allograft failure (CAF) by 27% (risk ratio [RR] 0.73, P<0.001). This effect was independent of its outcome on acute rejection. Censored graft survival using MMF versus azathioprine was significantly improved by Kaplan-Meier analysis at 4 years (85.61% v. 81.9%). The effect of an acute rejection episode on the risk of developing CAF seems to be increasing over time (RR=1.9, 1988-91; RR=2.9, 1992-94; RR=3.7, 1995-97).
Conclusion:
MMF therapy decreases the risk of developing CAF. This improvement is only partly caused by the decrease in the incidence of acute rejection observed with MMF; but, is also caused by an effect independent of acute rejection.
Insights
Mycophenolate Mofetil (MMF) reduces chronic allograft failure risk in kidney transplant patients. This benefit occurs independently of reducing acute rejection episodes, improving long-term graft survival.
Area of Science:
- Nephrology
- Immunosuppression
- Transplantation immunology
Background:
- Mycophenolate Mofetil (MMF) effectively reduces acute rejection in renal transplants.
- Long-term graft survival benefits of MMF are less clear.
- MMF may impact chronic allograft nephropathy independently of rejection.
Purpose of the Study:
- To evaluate the effect of MMF on chronic allograft failure (CAF) in renal transplant recipients.
- To determine if MMF's effect on CAF is independent of its impact on acute rejection.
Main Methods:
- Analysis of 66,774 renal transplant recipients from the U.S. registry (1988-1997).
- Utilized Cox proportional hazard regression for risk factor analysis.
- Employed Kaplan-Meier analysis for censored graft survival.
Main Results:
- MMF decreased the relative risk of developing CAF by 27% (RR 0.73, P<0.001).
- This protective effect on CAF was independent of acute rejection rates.
- MMF improved censored graft survival compared to azathioprine at 4 years (85.61% vs. 81.9%).
Conclusions:
- MMF therapy significantly decreases the risk of developing chronic allograft failure.
- The observed improvement in graft survival is partly due to reduced acute rejection and partly due to an independent effect of MMF.
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01:28Kidney Transplant I: Introduction