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Safe conversion of mycophenolate mofetil to azathioprine in kidney transplant recipients with sirolimus-based

Amgad E El-Agroudy1, Khaled F El-Dahshan, Ehab W Wafa

  • 1Urology and Nephrology Centre, University of Mansoura, Mansoura, Egypt. amgadelagroudy@hotmail.com

Nephrology (Carlton, Vic.)
|November 20, 2008
PubMed
Abstract

Insights

Switching stable kidney transplant patients from mycophenolate mofetil (MMF) to azathioprine (AZA) is safe, cost-effective, and reduces gastrointestinal issues without increasing rejection risk.

Area of Science:

  • Nephrology
  • Immunosuppression Therapy

Background:

  • Long-term use of mycophenolate mofetil (MMF) in kidney transplantation may increase risks of infection, malignancy, and costs.
  • Minimizing immunosuppression is a key goal in post-transplant care.

Purpose of the Study:

  • To evaluate the safety and efficacy of converting stable kidney transplant recipients from MMF to azathioprine (AZA).

Main Methods:

  • A randomized clinical trial involving 50 kidney allograft recipients on prednisone, sirolimus, and MMF.
  • Patients were randomized to either continue MMF or convert to AZA.
  • The study included patients with stable renal function and no recent rejection history.

Main Results:

  • No acute rejection episodes occurred in either group over 12 months.
  • Patient and graft survival/function remained similar between the azathioprine (AZA) and mycophenolate mofetil (MMF) groups.
  • The AZA group showed significantly fewer gastrointestinal complications and a daily cost reduction of over $US8.79 per patient.

Conclusions:

  • Conversion from MMF to AZA is well-tolerated and cost-effective in stable renal transplant recipients.
  • This immunosuppression minimization strategy did not increase rejection risk.
  • Larger, longer-term studies are needed to confirm long-term outcomes and safety.

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