INFECTIOUS COMPLICATIONS OCCURRING IN LIVER-TRANSPLANT RECIPIENTS RECEIVING MYCOPHENOLATE-MOFETIL

Background. Mycophenolate mofetil (MMF) is a new immunosuppressive age nt that is gaining widespread use in solid organ transplantation recip ients. A comprehensive assessment of infectious complications after it s use after liver transplantation has never been assessed, Methods, Ba cterial, fungal, and viral infections occurring after transplantation were compared for a cohort of consecutive liver transplant recipients who received MMF (because of suspected tacrolimus-related nephrotoxici ty or neurotoxicity) and a cohort who did not receive the drug. All pa tients received a tacrolimus-based primary immunosuppressive protocol, Results, Biopsy-proven acute rejection episodes within the first 6 mo nths after transplant occurred in 6% of MMF-treated patients but in 30 % of those who did not receive MMF (P=0.07), No significant difference s were found in occurrence of cytomegalovirus infection or disease, Pn eumocystis carinii, Aspergillus, or other fungal infection and hepatit is C virus recurrence between MMF-treated and untreated patients, Bact erial infections were more common in MMF-treated patients, but this co hort had a prolonged intensive care unit stay compared with patients w ho did not receive MMF. None of the MMF-treated patients with bacteria l infection had leukopenia, Conclusions. MMF use does not appear to be associated with an significantly increased risk of infection occurrin g after liver transplantation and is associated with fewer episodes of acute rejection.