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py of cyclosporine microemulsion, MMF, and prednisone had MMF withdrawn at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.