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Mycophenolate mofetil in pediatric renal transplantation: a single center experience

Omer A Raheem1, Mohamed H Kamel, Padraiq J Daly

  • 1Department of Urology, Beaumont Hospital, Beaumont, Ireland.

Pediatric Transplantation
|April 16, 2011
PubMed

Insights

Mycophenolate mofetil (MMF) did not lower rejection rates in pediatric kidney transplants. However, MMF significantly increased the risk of viral infections compared to older immunosuppression methods.

Area of Science:

  • Nephrology
  • Immunosuppression
  • Pediatric Transplantation

Background:

  • Pediatric renal transplantation requires effective immunosuppression to prevent graft rejection.
  • Mycophenolate mofetil (MMF) is a commonly used immunosuppressant, but its long-term safety and efficacy in pediatric populations require evaluation.
  • Previous immunosuppressive regimens provide a benchmark for assessing new treatments.

Purpose of the Study:

  • To evaluate the long-term safety and efficacy of MMF in pediatric renal transplant recipients.
  • To compare MMF-based immunosuppression with a non-MMF regimen in terms of rejection rates, graft loss, and infection incidence.
  • To determine if MMF offers advantages over previous immunosuppressive strategies in this patient group.

Main Methods:

  • Retrospective analysis of 47 pediatric renal transplants receiving MMF (1997-2006).
  • Comparison with a historical cohort of 59 pediatric renal transplants on a non-MMF regimen.
  • Assessment of acute rejection episodes, graft loss, and post-transplant infections.

Main Results:

  • The MMF group (n=47) showed similar acute rejection rates (23.4%) compared to the non-MMF group (n=59) (24%).
  • Graft loss was comparable: 1 (2.1%) in the MMF group versus 2 (3.3%) in the non-MMF group.
  • The incidence of post-transplant infections was significantly higher in the MMF group (44.68%) than in the non-MMF group (20.33%) (p < 0.0001).

Conclusions:

  • MMF use in pediatric renal transplantation did not reduce rejection rates or immunological graft loss.
  • MMF was associated with a significantly increased incidence of viral infections in pediatric kidney transplant recipients.
  • Current immunosuppressive protocols using MMF require careful monitoring for infection in pediatric renal transplant patients.

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