Prophylactic Effect of Mycophenolate Mofetil on Early Outcomes of Living Donor Kidney Transplantation

Abstract

Introduction. Living donor transplantation allows a priori scheduling and the recipient can receive immunosuppressive prophylaxis several days before surgery, which is preoperative induction therapy with oral agents. We evaluated the impact of preoperative mycophenolate mofetil on the outcomes of living donor kidney transplantations.

Materials and Methods. In a randomized controlled trial was from November 2008 to November 2010, 99 patients receiving their first living donor kidney transplantation were divided into the mycophenolate mofetil (500 mg) and placebo groups, and received 2 tablets per day for 5 days before transplantation.

Results.  Forty-nine patients received mycophenolate mofetil and 48 received placebo. The mean serum creatinine on discharge day and hospitalization period were significantly less with mycophenolate mofetil compared to placebo (1.62 ± 1.00 mg/dL versus 1.22 ± 0.24 mg/dL, P = 0.03 and 20.8 ± 11.2 days versus 13.5 ± 4.4 days, P < .001, respectively). No delayed graft function was observed. Slow graft function was 2-fold higher in the placebo group (14.6% versus 8.2%, P = .32). Acute rejection was seen in 12.2% of the patients with mycophenolate mofetil and in 29.2% of the controls (P = .04). Serum creatinine levels at discharge were significantly lower in the mycophenolate mofetil group compared with that in the placebo group (P = .03).

Conclusions. Prophylactic administration of mycophenolate mofetil before living donor kidney transplantation reduced hospitalization period, improved early graft function, and decreased the risk of acute rejection in the first month posttransplant.