Effect of mycophenolate mofetil on long-term outcomes in African American renal transplant recipients

African American renal transplant recipients have poorer graft survival. A study using the United States Renal Data Registry documented an improvement in graft survival for patients who took mycophenolate mofetil (MMF) compar ed with azathioprine (AZA). This analysis did not address the impact of MMF on African American renal transplant recipients. The present study aimed t o quantify potential beneficial effects of MMF therapy on long-term renal a llograft survival in African Americans. With the use of the United States R enal Data Registry, all adult Caucasian and African American patients who h ad received a primary renal transplant between 1988 and 1997 were analyzed by Kaplan-Meier analysis and Cox proportional hazard models. Primary study end points were death with a functioning graft and graft failure censored f or death. A total of 57,926 patients were studied. For African Americans, 3 -yr patient survival was 96.3 versus 93.2% (P < 0.001) for MMF and AZA, res pectively. Three-yr death-censored graft survival for African Americans was 85.8 versus 75.1% (P < 0.001) for MMF and AZA, respectively. For Caucasian s, 3-yr patient survival was 97.3 versus 93.2% for MMF and AZA, respectivel y. Three-yr death-censored graft survival for Caucasians was 90.1 versus 86 .4% (P < 0.001) for MMF and AZA, respectively. By multivariate analysis, MM F was associated with a significant reduction in the relative risk for all study end points in African Americans. MMF therapy is associated with both improved patient and death-censored graft survival in African American rena l transplant recipients. This benefit is comparable to the benefit of MMF i n Caucasian renal transplant recipients.