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Five-year outcome in pediatric patients with mycophenolate mofetil-based renal transplantation

Therese C Jungraithmayr1, Silke Wiesmayr, Astrid Staskewitz

  • 11 Universitätsklinik für Kinder und Jugendheilkunde, Innsbruck, Austria.

Transplantation
|April 27, 2007
PubMed
Abstract

Insights

Mycophenolate mofetil (MMF) improved long-term graft survival in pediatric kidney transplant patients compared to azathioprine (AZA). Early acute rejections impacted graft half-life, highlighting the need to minimize rejections for better long-term outcomes.

Area of Science:

  • Pediatric Nephrology
  • Transplantation Immunology
  • Immunosuppressive Therapy

Background:

  • Mycophenolate mofetil (MMF) is a safe immunosuppressant for pediatric renal transplant recipients.
  • Long-term data on MMF in pediatric kidney transplant patients is limited.

Purpose of the Study:

  • To compare long-term graft survival and renal function in pediatric kidney transplant patients treated with MMF versus azathioprine (AZA).
  • To evaluate the impact of early acute rejections on long-term graft outcomes.

Main Methods:

  • Retrospective analysis of 140 pediatric renal transplant patients.
  • Comparison of MMF versus AZA, both combined with cyclosporine A and prednisone.
  • Focus on graft survival, renal function, and rejection rates over long-term follow-up.

Main Results:

  • MMF demonstrated significantly higher graft survival (90.7%) compared to AZA (68.5%) after 5 years (P<0.001).
  • MMF also showed improved rejection-free survival (51.2%) versus AZA (37.0%) (P<0.05).
  • Early acute rejections were associated with reduced graft half-life, particularly in the AZA group.

Conclusions:

  • MMF-based immunosuppression enhances long-term graft survival in pediatric kidney transplant recipients without increasing side effects.
  • Minimizing early acute rejections is crucial for preserving renal function and improving long-term quality of life.
  • Further research should focus on strategies to decrease acute rejections and optimize renal function preservation.

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