Long-term benefits of mycophenolate mofetil after heart transplantation

Transplant coronary artery disease and malignancy are the major limitations to survival after heart transplantation. In a randomized trial, mycophenolate mofetil (MMF) significantly improved 3-year survival over azathioprine, but the expected reduction in intracoronary ultrasound evidence of vasculopathy was not found on initial analysis using unmatched sites. On reanalysis using matched sites, a highly significant reduction in maximum intimal thickness was shown with MMF. Malignancy was numerically but not significantly lower at 3 years; in open label experience up to 7 years, it is diminished by 37% on MMF. MMF protects heart transplant recipients against both vasculopathy and malignancy.