scholarly journals Mycophenolic Acid Concentration on Vietnamese Renal Transplant Recipients

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Dung Thi Mai Dung ◽  
An Phan Hai Ha ◽  
Dong Van Le ◽  
Lan Thi Phuong Dam ◽  
Thuan Quang Huynh
Keyword(s):  
Renal Transplant ◽  
Mycophenolic Acid ◽  
Calcineurin Inhibitor ◽  
Drug Level ◽  
Therapeutic Drug ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplantation ◽  
Kidney Recipients ◽  
Number Of Patients

Background: Kidney recipients often use a calcineurin inhibitor and a proliferation inhibitor after transplantation. The therapeutic drug monitoring for calcineurin inhibitor is more simple and feasible in clinical than proliferation inhibitor. In Vietnam, mycophenolic acid is a popular proliferation inhibitor used for transplantation patients. Although therapeutic mycophenolic acid monitoring is so important in treating kidney transplantation, the monitoring is still difficult to execute in Vietnam. Objectives: This study aimed to determine the MPA concentration on Vietnamese renal transplant recipients. Methods: This observational study was conducted on 35 adult kidney recipients to evaluate the MPA concentration at five sampling time points (predose, 1, 2, 3, and 6 hours) on day 3, day 10, and month 6 after transplantation. Results: Plasma MPA trough levels (C0) were 2.32 ± 1.47;1.58 ± 1.39; 2.29 ± 1.4 mg/L and the MPA-AUC0-12 h values were 50.1 ± 20.4; 41.9 ± 14.5; 60.3 ± 25.9 mg.h/L on day 3, day 10, and month 6. The number of patients who reached MPA-AUC0-12 h values of 30 - 60 mg.h/L was 18 (51.4%), 23 (65.7%) and 17 (51.5%) on day 3, day 10, and month 6, respectively. The number of patients who achieved the MPA C0 values of 1.5 - 2.5 mg/L was 15 (42.9 %), 14 (40%), and 10 (30.3%) on day 3, day 10, and month 6, respectively; and the linear correlation coefficients between AUC0-12 h and C0 were 0.652, 0.415, and 0.752, respectively. Conclusions: In renal transplant patients, the MPA-AUC0-12 h was lower on day 3 and day 10 post-transplantation than month 6 for the half dose of MMF or MPS. Therefore, MPA therapeutic drug level should be monitored usually in transplantation patients who use MPA.

Therapeutic Drug Monitoring of Mycophenolic Acid in Renal Transplant Recipients

2005 ◽  
Vol 37 (2) ◽  
pp. 859-860 ◽  
Author(s):  
M. Okamoto ◽  
Y. Wakabayashi ◽  
A. Higuchi ◽  
Y. Kadotani ◽  
S. Ogino ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Therapeutic Drug Monitoring ◽  
Mycophenolic Acid ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

scholarly journals Comparison of the Emit Immunoassay with HPLC for Therapeutic Drug Monitoring of Mycophenolic Acid in Pediatric Renal-Transplant Recipients on Mycophenolate Mofetil Therapy

2002 ◽  
Vol 48 (3) ◽  
pp. 517-525 ◽  
Author(s):  
Lutz T Weber ◽  
Maria Shipkova ◽  
Victor W Armstrong ◽  
Natalie Wagner ◽  
Ekkehard Schütz ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Renal Transplant ◽  
Acute Rejection ◽  
Mycophenolic Acid ◽  
Therapeutic Drug ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Pediatric Renal Transplant ◽  
Pediatric Renal Transplant Recipients

Abstract Background: HPLC is currently the preferred method for accurate measurement of mycophenolic acid (MPA). This study was designed to validate the Emit compared with HPLC in relation to clinical outcome measurements. Methods: Pediatric renal-transplant recipients (n = 50) on an immunosuppressive triple regimen consisting of cyclosporin A, prednisone, and mycophenolate mofetil (600 mg/m2 twice per day) were investigated in an open-label prospective study. Pharmacokinetic profiles over 12 h were obtained at 1 week, 3 weeks, 3 months, and 6 months posttransplant. Plasma MPA was measured by both reversed-phase HPLC and the Emit immunoassay. Results: There was an association between the risk of acute rejection episodes and low area under the curve values from t0 to t12h (AUC0–12) for MPA (MPA-AUC0–12) or predose concentrations of MPA derived from both HPLC and Emit measurements. According to ROC analysis, an AUC value of 33.8 mg · h/L for MPA from t0 to t12h (MPA-AUC0–12) determined by HPLC had a diagnostic sensitivity of 80% and a diagnostic specificity of 57%. The corresponding value of the Emit was 36.1 mg · h/L. For the predose concentration (MPA-c12), a concentration of 1.2 mg/L determined by HPLC and 1.4 mg/L determined by Emit gave a sensitivity of 80% and a specificity of 60%, respectively. There was no association of any pharmacokinetic variables derived from total MPA measurements with an increased risk of side effects related to mycophenolate mofetil. Conclusions: The Emit assay appears to have a comparable diagnostic efficacy to HPLC for assessing the risk of acute rejection in pediatric renal-transplant recipients. However, because of the cross-reactivity of the antibody used in the Emit assay with the active MPA acyl glucuronide metabolite, the decision thresholds for the Emit were higher than those calculated from HPLC measurements.

THERAPEUTIC DRUG MONITORING OF MYCOPHENOLIC ACID IN RENAL TRANSPLANT RECIPIENTS

2004 ◽  
Vol 78 ◽  
pp. 460-461
Author(s):  
M Okamoto ◽  
K Akioka ◽  
Y Wakabayashi ◽  
A Higuchi ◽  
Y Kadotani ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Therapeutic Drug Monitoring ◽  
Mycophenolic Acid ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

Subclinical Rejection and Immunosuppression in Pediatric Kidney Transplant Recipients : Single Centre Study

2021 ◽  
Vol 14 (3) ◽  
pp. 1149-1159
Author(s):  
Fatina I Fadel ◽  
Abeer M Nour ElDin Abd ElBaky ◽  
Mohamed A Abdel Mawla ◽  
Wesam I Moustafa ◽  
Gamal Eldin Saadi ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Triple Therapy ◽  
Low Dose ◽  
Case Series ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplantation ◽  
Number Of Patients ◽  
Pediatric Renal Transplant ◽  
Subclinical Rejection

Background: By the time of histological confirmation of rejection is achieved, renal scarring may for treatment as a realistic option . This study aims to study the subclinical pathological graft data and to evaluate the histopathological impact of different immunosuppression protocols in pediatric renal transplant recipients. Methods: This is a case series that included twenty living donor renal transplant recipients. All included cases received the classic triple immunotherapy for at least one month post-transplantation [Steroids, calconurine inhibitors (CNI), and mycofenlolic mofetile (MMF)]. Based on their immunological risk stratification; included cases were divided into 2 groups: group (A) continued on CNI based triple therapy protocol; group (B) shifted to evirolimus /low dose CNI protocol. Surveillance biopsies were done for all cases at one and four month post-transplantation. Results: One and four month biopsies revealed subclinical rejection (including borderline changes) in 4 (20%) cases and 6 (30%) cases respectively. The number of patients received tacrolimus/MMF therapy significantly increased (p=0.02) while that of patients on everloimus/low dose CNI significantly decreased (p=0.014) due to drug modifications based on four month surveillance biopsy data. Conclusion: Subclinical rejection is not uncommon in pediatric renal graft recipients which makes surveillance biopsy might be of help. Early usage of evirolimus/low CNI protocol is associated with higher rejection rate than triple therapy.

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