Impact of gastrointestinal-related side effects on mycophenolate mofetil dosing and potential therapeutic strategies.

Abstract:

:In renal transplant patients receiving mycophenolate mofetil (MMF), maintaining an adequate dosing regimen has been shown to maximize short- and long-term outcomes. Gastrointestinal (GI) adverse events associated with MMF are frequent, and lead to MMF dose reduction or withdrawal in 40-50% of cases. Among MMF-treated patients experiencing GI complications, one analysis has reported MMF discontinuation to be associated with almost a threefold increase in risk of graft loss, while a dose reduction > or = 50% carried over a twofold increase in risk. If GI symptoms improve and the pre-reduction MMF dose is resumed the increased risk of graft loss may be reversed, but continuing intolerance can make this difficult to achieve. Investigation of contributing factors is important and may alleviate symptoms. Conversion to enteric-coated mycophenolate sodium (EC-MPS) may be an effective option. Two open-label studies using patient-reported outcomes data have shown a significant and clinically relevant benefit in GI-related symptom burden after conversion from MMF to EC-MPS. In conclusion, monitoring of GI complications is essential following renal transplantation, and maintaining adequate mycophenolic acid exposure should be a priority when considering treatment options.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Bunnapradist S,Ambühl PM

doi

10.1111/j.1399-0012.2008.00892.x

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

815-21

issue

6

eissn

0902-0063

issn

1399-0012

pii

CTR892

journal_volume

22

pub_type

杂志文章,评审
  • Tuberculosis in southern Chinese renal-transplant recipients.

    abstract:OBJECTIVES:To analyze the characteristics of tuberculosis (TB) in Southern Chinese renal transplant recipients, and summarize the corresponding experiences in diagnosis and management. METHOD:Retrospectively study 41 documented post-transplant TB cases out of the 2333 patients who received kidney transplantation in th...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2008.00878.x

    authors: Chen SY,Wang CX,Chen LZ,Fei JG,Deng SX,Qiu J,Li J,Chen GO,Fu HM,Xie CM

    更新日期:2008-11-01 00:00:00

  • A high antithymocyte globulin dose increases the risk of relapse after reduced intensity conditioning HSCT with unrelated donors.

    abstract::The study included 110 consecutive patients with hematological malignancies receiving fludarabine-based reduced intensity conditioning (RIC) and hematopoietic stem cell transplantation (HSCT) from matched unrelated donors. The median age was 55 yr (range 11-68) and all but 15 patients received peripheral blood stem ce...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12131

    authors: Remberger M,Ringdén O,Hägglund H,Svahn BM,Ljungman P,Uhlin M,Mattsson J

    更新日期:2013-07-01 00:00:00

  • Apolipoprotein E gene polymorphism in renal transplant recipients: effects on lipid metabolism, atherosclerosis and allograft function.

    abstract:INTRODUCTION:Atherosclerosis is a serious complication and leading cause of mortality in renal transplant recipients (RTRs). Hyperlipidemia may be associated with progression of renal disease and chronic allograft dysfunction. Similarities in the pathogenesis of glomerulosclerosis and atherosclerosis have been proposed...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2004.00162.x

    authors: Kahraman S,Kiykim AA,Altun B,Gençtoy G,Arici M,Gulsun M,Erdem Y,Yasavul U,Turgan C,Cağlar S

    更新日期:2004-06-01 00:00:00

  • Heart transplantation in the early phase of the COVID-19 pandemic: A single-center case series.

    abstract::The infectious disease coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. The impact of COVID-19 on solid organ transplantations, including heart transplantation, is currently unclear. Many transplant programs have been forced to swiftly re-evaluate and adapt th...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.14042

    authors: Hsu JJ,Al-Saffar F,Ardehali R,Baas AS,Carlson M,Cruz D,Deng M,Fan A,Fraschilla S,Gaynor P,Kamath M,Kubak BM,Schaenman J,Stimpson E,Vucicevic D,Ardehali A,Nsair A

    更新日期:2020-09-01 00:00:00

  • Low infectious complications in segmental living related small bowel transplantation in adults.

    abstract::Clinical small bowel transplantation (SBTx) has been associated with a high rate of infectious complications. Laparotomy, preservation injury, abnormal motility, lymphatic disruption, aberrant systemic venous drainage, rejection and antibiotic therapy could all be implicated in the etiology of these complications. In ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1034/j.1399-0012.2000.140609.x

    authors: Cicalese L,Sileri P,Asolati M,Rastellini C,Abcarian H,Benedetti E

    更新日期:2000-12-01 00:00:00

  • Renal outcomes of simultaneous liver-kidney transplantation compared to liver transplant alone for candidates with renal dysfunction.

    abstract::It is unclear whether a concomitant kidney transplant grants survival benefit to liver transplant (LT) candidates with renal dysfunction (RD). We retrospectively studied LT candidates without RD (n = 714) and LT candidates with RD who underwent either liver transplant alone (RD-LTA; n = 103) or simultaneous liver-kidn...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12479

    authors: Brennan TV,Lunsford KE,Vagefi PA,Bostrom A,Ma M,Feng S

    更新日期:2015-01-01 00:00:00

  • Sequential biological immunosuppression. Induction therapy with rabbit antithymocyte globulin.

    abstract::This paper describes 108 consecutively treated patients receiving 109 cadaveric (CD) and living donor (LD) renal allografts using a protocol of quadruple sequential immunosuppression with a rabbit anti-human thymocyte IgG (Thymoglobuline), azathioprine, tapering corticosteroids, and delayed introduction of cyclosporin...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:

    authors: Guttmann RD,Flemming C

    更新日期:1997-06-01 00:00:00

  • Clinical outcome of heart transplant recipients receiving tacrolimus with or without mycophenolate mofetil.

    abstract::Tacrolimus (TAC) is a calcineurin inhibitor that is used for cardiac allograft rejection. Efficacy and safety data of a combined TAC/mycophenolate mofetil (MMF) therapy in comparison with a TAC/cortisone therapy in heart recipients are lacking. We analysed the clinical outcome of 41 patients who received TAC in combin...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2006.00504.x

    authors: Fuchs U,Tenderich G,Zittermann A,Szabados F,Minami K,Koerfer R

    更新日期:2006-07-01 00:00:00

  • Prevalence and immunohistochemical findings of subclinical kidney allograft rejection and its association with graft outcome.

    abstract::Subclinical acute rejection (SAR) occurs in about 30% of stable renal transplant patients and may be a risk factor for a poor allograft outcome. In the present study, the prevalence and clinical features of subclinical rejection, and the expression of immune activation markers in surveillance graft biopsies were asses...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2004.00170.x

    authors: Veronese FV,Noronha IL,Manfro RC,Edelweiss MI,Goldberg J,Gonçalves LF

    更新日期:2004-08-01 00:00:00

  • Ezetimibe effectively lowers LDL-cholesterol in cardiac allograft recipients on stable statin therapy.

    abstract::We investigated tolerability and efficacy of ezetimibe treatment (10 mg/d) in 25 heart allograft recipients already on stable statin therapy. Total cholesterol (TC), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C), triglycerides (TG), immunosuppressant drug levels, laboratory and clinical parameters ...

    journal_title:Clinical transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1399-0012.2008.00838.x

    authors: Konstandin MH,Blessing E,Doesch A,Ammon K,Koch A,Wabnitz GH,Gleissner CA,Remppis A,Katus HA,Dengler TJ

    更新日期:2008-09-01 00:00:00

  • Early- and long-term outcomes of liver transplantation with rescue allocation grafts.

    abstract::In France, liver grafts which have been refused by at least five centers are proposed as rescue allocation (RA). The aim of this study is to clarify the feasibility and safety of RA grafts in liver transplantation (LT). Short- and long-term outcomes of patients who received RA grafts (RA group) were compared with thos...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.14046

    authors: Kitano Y,Allard MA,Nakada S,Beghdadi N,Karam V,Vibert E,Sa Cunha A,Castaing D,Cherqui D,Baba H,Adam R

    更新日期:2020-07-19 00:00:00

  • Single-dose rATG induction at renal transplantation: superior renal function and glucoregulation with less hypomagnesemia.

    abstract:UNLABELLED: BACKGROUND:Rabbit anti-thymocyte globulin (rATG) induction reduces reperfusion injury and improves renal function in kidney recipients by means of properties unrelated to T-cell lysis. Here, we analyze intensive rATG induction (single dose, rATG(S) , vs. divided dose, rATG(D) ) for improved renal function ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1399-0012.2011.01425.x

    authors: Stevens RB,Lane JT,Boerner BP,Miles CD,Rigley TH,Sandoz JP,Nielsen KJ,Skorupa JY,Skorupa AJ,Kaplan B,Wrenshall LE

    更新日期:2012-01-01 00:00:00

  • Blood glutathione as a marker of cardiac allograft vasculopathy in heart transplant recipients.

    abstract:BACKGROUND:Cardiac allograft vasculopathy (CAV) limits survival after heart transplantation (HTx). Between immunologic and non-immunologic factors, reactive oxygen species generation has been proposed as pathogenetic mechanism. This study was aimed at evaluating redox status in HTx recipients and verifying whether it c...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2005.00352.x

    authors: De Chiara B,Bigi R,Campolo J,Parolini M,Turazza F,Masciocco G,Frigerio M,Fiorentini C,Parodi O

    更新日期:2005-06-01 00:00:00

  • Plasma mycophenolic acid concentration and the clinical outcome after lung transplantation.

    abstract:BACKGROUND:The therapeutic drug monitoring of mycophenolic acid (MPA) has been investigated for renal and heart transplantations; however, its usefulness in lung transplantation is unclear. METHODS:The MPA area under the plasma concentration-time curve (AUC) was calculated in 59 adult lung transplant recipients. The M...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.14088

    authors: Yabuki H,Matsuda Y,Watanabe T,Eba S,Hoshi F,Hirama T,Oishi H,Sado T,Noda M,Sakurada A,Kikuchi M,Yamaguchi H,Mano N,Okada Y

    更新日期:2020-12-01 00:00:00

  • Impact of venous drainage on regeneration of the anterior segment of right living-related liver grafts.

    abstract::The effect of additional venous reconstruction on morphologic and functional regeneration of the anterior segment of right-lobe liver grafts was compared among three groups according to graft type: right liver graft without the middle hepatic vein (MHV) or MHV tributaries (n=7), with MHV tributaries (n=25) and with th...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2006.00515.x

    authors: Mizuno S,Iida T,Yagi S,Usui M,Sakurai H,Isaji S,Uemoto S

    更新日期:2006-07-01 00:00:00

  • Prolonged cardiac allograft ischemic time--no impact on long-term survival but at what cost?

    abstract:INTRODUCTION:The aim of this paper was to review the outcomes of cardiac transplantation with regards to short- and long-term survival, focusing particularly on patients who receive organs with long ischemic times and the resource utilization necessary to support such patients through their postoperative period. METHO...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2007.00644.x

    authors: Marasco SF,Esmore DS,Richardson M,Bailey M,Negri J,Rowland M,Kaye D,Bergin PJ

    更新日期:2007-05-01 00:00:00

  • Late acute rejection after liver transplantation impacts patient survival.

    abstract::Hepatic allograft rejection still remains an important problem following liver transplantation. Early acute rejection, occurring within three months of transplant, is a common event and usually of lesser significance with respect to prognosis than other non-immune-related post-transplant morbidities. However, little i...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2007.00788.x

    authors: Uemura T,Ikegami T,Sanchez EQ,Jennings LW,Narasimhan G,McKenna GJ,Randall HB,Chinnakotla S,Levy MF,Goldstein RM,Klintmalm GB

    更新日期:2008-05-01 00:00:00

  • Impact of donor and recipient age difference on long-term allograft survival after living donor renal transplantation: analysis of 478 cases.

    abstract:INTRODUCTION:Either deceased or living-related renal transplantation constitutes the best therapeutic option for patients with end-stage renal disease. In this retrospective study, an attempt to identify parameters that affect allograft survival in living donor renal transplantation was made. METHODS:Between January 2...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12219

    authors: Kostakis ID,Moris DN,Barlas A,Bokos I,Darema M,Theodoropoulou E,Karaolanis G,Kostakis A,Boletis I,Zavos G

    更新日期:2013-11-01 00:00:00

  • Immunoreactive trypsinogen levels in pediatric patients with intestinal failure awaiting intestinal transplantation.

    abstract::The aim of this study was to evaluate pancreatic function in total parenteral nutrition (TPN)-dependent children with permanent intestinal failure by measuring immunoreactive trypsinogen (IRT) levels. Between 1992 and 1996, 105 pediatric patients with permanent intestinal failure were referred to the Children's Hospit...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1034/j.1399-0012.1999.130505.x

    authors: Rovera GM,Sigurdsson L,Reyes J,Bouch LD,Naylor EW,Kocoshis SA

    更新日期:1999-10-01 00:00:00

  • Attenuated early inflammatory response in solid organ recipients with COVID-19.

    abstract::Immunosuppression leaves transplanted patients at particular risk for severe acute respiratory syndrome 2 (SARS-CoV-2) infection. The specific features of coronavirus disease 2019 (COVID-19) in immunosuppressed patients are largely unknown and therapeutic experience is lacking. Seven transplanted patients (two liver, ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.14027

    authors: Bösch F,Börner N,Kemmner S,Lampert C,Jacob S,Koliogiannis D,Stangl M,Michel S,Kneidinger N,Schneider C,Fischereder M,Irlbeck M,Denk G,Werner J,Angele MK,Guba MO

    更新日期:2020-10-01 00:00:00

  • Crystalloid flush with backward unclamping may decrease post-reperfusion cardiac arrest and improve short-term graft function when compared to portal blood flush with forward unclamping during liver transplantation.

    abstract::During liver transplant (LT), the release of vasoactive substances into the systemic circulation is associated with severe hemodynamic instability that is injurious to the recipient and/or the post-ischemic graft. Crystalloid flush with backward unclamping (CB) and portal blood flush with forward unclamping (PF) are t...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12130

    authors: Fukazawa K,Nishida S,Hibi T,Pretto EA Jr

    更新日期:2013-07-01 00:00:00

  • Attitude toward xenotransplantation of patients prior and after human organ transplantation.

    abstract::Xenotransplantation is a potential strategy to overcome the shortage of human donor organs. As this technique has a major medical and psychological impact on patients and their family and friends, the attitude of patients currently waiting for organ transplantation is important. Therefore, we conducted a survey on the...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2010.01296.x

    authors: Stadlbauer V,Stiegler P,Müller S,Schweiger M,Sereingg M,Tscheliessnigg KH,Freidl W

    更新日期:2011-05-01 00:00:00

  • Calcification score evaluation in patients listed for renal transplantation.

    abstract::Based on native CT scans of the pelvic region using a standardized calcification score, evaluation of iliac vascular calcification was performed between 2008 and 2012 prior to listing for renal transplantation in 205 patients with chronic kidney disease. Vascular calcification showed a decrease from proximal to distal...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12888

    authors: Kahn J,Ram LM,Eberhard K,Groselj-Strele A,Obermayer-Pietsch B,Müller H

    更新日期:2017-03-01 00:00:00

  • Ganciclovir exposure under a 450 mg daily dosage of valganciclovir for cytomegalovirus prevention in kidney transplantation: a prospective study.

    abstract::This prospective study aimed at determining the ganciclovir exposure observed under a daily dosage of 450 mg valganciclovir routinely applied to kidney transplant recipients with a GFR above 25 mL/min at risk for cytomegalovirus (CMV) disease. Ganciclovir levels at trough (C(trough)) and at peak (C₃(h)) were measured ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2009.01205.x

    authors: Manuel O,Pascual M,Perrottet N,Lamoth F,Venetz JP,Decosterd LA,Buclin T,Meylan PR

    更新日期:2010-11-01 00:00:00

  • Kaposi's sarcoma in two primary liver allograft recipients occurring under FK506 immunosuppression.

    abstract::Of 1463 liver allograft recipients receiving the combination of FK506 and steroids as their primary immunosuppressive regimen, 2 patients developed Kaposi's sarcoma. Although previously described as a complication of organ transplantation, this is the first case report of Kaposi's sarcoma occurring in association with...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:

    authors: Kadry Z,Bronsther O,Van Thiel DH,Randhawa P,Fung JJ,Starzl TE

    更新日期:1993-01-01 00:00:00

  • Multivisceral transplant is a viable treatment option for patients with non-resectable intra-abdominal fibromatosis.

    abstract:BACKGROUND:Intra-abdominal fibromatosis often involves the mesentery root which is non-resectable by conventional surgery. Multivisceral transplant (MVT), as a potential cure to non-resectable fibromatosis, has rarely been reported and the prognosis is unknown. METHODS:Six patients who underwent MVT for intra-abdomina...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.13186

    authors: Chi Z,Mangus RS,Kubal CA,Chen S,Lin J

    更新日期:2018-03-01 00:00:00

  • Heparin-induced thrombocytopenia following pancreatectomy and islet auto-transplantation.

    abstract::We report the case of a female with chronic pancreatitis who underwent multiple surgical procedures leading to total resection of the pancreas with successful islet auto-transplantation. Postoperatively, she developed heparin-induced thrombocytopenia. Heparinization prior to islet infusion is currently recommended to ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2005.00457.x

    authors: Rastellini C,Brown ML,Cicalese L

    更新日期:2006-03-01 00:00:00

  • High mortality in orthotopic liver transplant recipients who require hemodialysis.

    abstract::Acute renal failure is a significant risk factor for death in patients with liver failure. The goal of this study was to analyze the impact of peri-transplant dialysis on the long-term mortality of liver transplant recipients. We performed a single-center, retrospective cohort study of 743 adult liver transplants; pat...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2010.01238.x

    authors: Zand MS,Orloff MS,Abt P,Patel S,Tsoulfas G,Kashyap R,Jain A,Safadjou S,Bozorgzadeh A

    更新日期:2011-03-01 00:00:00

  • MR cholangiography in orthotopic liver transplantation: sensitivity and specificity in detecting biliary complications.

    abstract:BACKGROUND:To assess the diagnostic value of magnetic resonance cholangiography (MRC) when evaluating biliary complications in a large series of liver transplants. METHODS:One hundred and twenty-nine patients prospectively underwent magnetic resonance (MR) imaging and MR cholangiography at 1.5-T device after orthotopi...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2009.01190.x

    authors: Boraschi P,Donati F,Gigoni R,Volpi A,Salemi S,Filipponi F,Falaschi F

    更新日期:2010-07-01 00:00:00

  • Prevention of hepatitis B virus recurrence after liver transplantation.

    abstract::Liver transplantation for hepatitis B virus (HBV)-related liver disease has changed from a contraindication to outcomes comparable with non-HBV-related liver transplantations during the last two decades. Mainly the implementation of immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and the use of nucleoside ana...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,评审

    doi:10.1111/j.1399-0012.2006.00609.x

    authors: Eisenbach C,Sauer P,Mehrabi A,Stremmel W,Encke J

    更新日期:2006-01-01 00:00:00