Withdrawal of mycophenolate mofetil in stable renal transplant recipients

Background. Mycophenolate mofetil (MMF) has been demonstrated to decrease e pisodes of acute rejection in renal transplant recipients during the first year after transplantation. The utility of MMF after 1 year is less clear. Methods. Forty-five stable renal transplant recipients on maintenance thera py of cyclosporine microemulsion, MMF, and prednisone had MMF withdrawn at approximately 1 year after transplantation. A matching concurrent group of 45 stable renal transplant recipients served as the case control group. Results. Two of 45 patients in the MMF withdrawal group suffered an acute r ejection episode as opposed to 1 of 45 in the control group. Both patients who rejected in the withdrawal group had adequate cyclosporine levels and h ad no recent decrease in prednisone dose. There was no evidence of an incre ased incidence of proteinuria or increased creatinine levels in the MMF wit hdrawal group. Conclusion. In general, withdrawal of MMF in stable renal transplant recipi ents is well tolerated. No increased risk of rejection could be demonstrate d in this patient group. A larger study will be needed to confirm our resul t.