Measurement of mycophenolate mofetil plasma levels after heart transplantation and a potential side effect of high levels

Mycophenolate mofetil (MMF) is gaining momentum in its use as an immunosupp ressant and in the field of heart transplantation because of its efficacy a nd ease of use without a reported need to monitor plasma levels. We describ e a case in which standard dosage of MMF (initially 1.5 g twice daily) prod uced elevated trough levels of mycophenolic acid (MPA). Although organ reje ction was eradicated by the use of MMF, the patient developed severe anemia , which required repeated blood transfusions while the patient was on thera py. This case illustrates the potential value of monitoring MPA concentrati ons.