MYCOPHENOLATE MOFETIL FOR MAINTENANCE THERAPY IN KIDNEY-TRANSPLANTATION

Mycophenolate mofetil (MMF) is a new immunosuppressive drug that selec tively inhibits de novo purine synthesis. It has been tested in three large double-blind controlled trials for the prevention of rejection i n renal transplant patients. These studies indicate that the use of MM F dramatically decreases the incidence of biopsy-proven rejection, the use of multiple courses of steroids for rejection, and the use of ant ilymphocyte preparations for treatment of rejection. The drug was well tolerated with an acceptable safety profile, The main side effects we re gastrointestinal (nausea, vomiting, diarrhea), but seldom resulted in the cessation of drug therapy. Hematologic side effects similar to those with azathioprine occurred and were reversible. There was a slig ht increase in CMV-invasive disease with the use of MMF, but no deaths . Rates of malignancy were within published ranges for transplant reci pients. Mycophenolate mofetil is a safe and efficacious drug for preve ntion of rejection in kidney transplant recipients.