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Titolo:
The impact of routine mycophenolate mofetil drug monitoring on the treatment of cardiac allograft rejection
Autore:
Yamani, MH; Starling, RC; Goormastic, M; Van Lente, F; Smedira, N; McCarthy, P; Young, JB;
Indirizzi:
Cleveland Clin Fdn, Kaufman Ctr Heart Failure, Dept Cardiol & CardiothoracSurg, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 acSurg, Cleveland, OH 44195 USA
Titolo Testata:
TRANSPLANTATION
fascicolo: 11, volume: 69, anno: 2000,
pagine: 2326 - 2330
SICI:
0041-1337(20000615)69:11<2326:TIORMM>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEART-TRANSPLANT RECIPIENTS; RENAL-TRANSPLANTATION; COMBINATION THERAPY; ACID; PHARMACOKINETICS; RS-61443; TACROLIMUS; EXPERIENCE; PREVENTION; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Starling, RC Cleveland Clin Fdn, Dept Cardiol F25, Heart Transplant Med Serv, 9500 Euclid Ave, Cleveland, OH 44195 USA Cleveland Clin Fdn 9500 EuclidAve Cleveland OH USA 44195 USA
Citazione:
M.H. Yamani et al., "The impact of routine mycophenolate mofetil drug monitoring on the treatment of cardiac allograft rejection", TRANSPLANT, 69(11), 2000, pp. 2326-2330

Abstract

Introduction, Mycophenolate mofetil (MMF) is a unique immunosupressive agent that has been shown to be efficacious in the treatment of cardiac allograft rejection. The utility of therapeutic drug monitoring on rejection prophylaxis and treatment is inconclusive. This study was undertaken to evaluate the incidence of rejection in relation to MMF trough level following heart transplantation. Methods. Between May 1998 and February 1999, we retrospectively analyzed the clinical outcome of 215 heart transplant patients who had routine monitoring of MMF trough level at the time of scheduled endomyocardial biopsy. Patients were divided into three groups according to the time interval post transplant, and were evaluated in relation to the MMF trough level. Group I,104 patients within 6 months of transplant; Group II, 90 patients, 6-12 months post transplant; and Group III, 71 patients beyond one year of transplant. Fifty patients had samples in more than one group. Rejection was defined as Grade greater than or equal to 3A based on ISHLT criteria. Mean follow-up period was 179+/-52 days. Results, A significantly decreased incidence of rejection was noted in thesamples with MMF trough level greater than or equal to 2 mg/l compared to those with less than 2 mg/l in patients evaluated within the first year of transplant (Group I: 8.8% vs. 14.9%, Group II: 4.2% vs. 11.3%, both P=0.05). In the presence of therapeutic cyclosporine (CSA) or tacrolimus (FK) blood levels, the incidence of rejection decreased significantly when MMF trough level was greater than or equal to 2 mg/l compared to samples with MMF trough level <2 mg/l (3.6% vs. 14.4%, P=0.005). No significant difference wasnoted in the presence of subtherapeutic CSA or FK levels (15.4% vs. 13.9%,P=NS)Conclusions. Monitoring of MMF trough levels may play a role in the management of cardiac transplant recipients during the first year post transplant.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/10/20 alle ore 06:50:33