Mycophenolate mofetil dose reduction for gastrointestinal intolerance is associated with increased rates of rejection in heart transplant patients

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Paul J GaliwangoHeather J Ross

Abstract

Gastrointestinal (GI) intolerance to mycophenolate mofetil (MMF) is a frequent problem. We conducted a retrospective analysis of all the heart transplant patients followed up at the Toronto General Hospital from the years 1999 to 2006 to determine the impact of dose reductions for GI intolerance on rejection rates. The charts of all patients followed up in the heart transplant clinic at the Toronto General Hospital from the years 1999 to 2006 were reviewed. Sustained significant rejection was defined as an International Society of Heart and Lung Transplantation grade 2 or higher on 2 successive biopsies. The Student's t-test was used to compare rates of rejection between populations. Mycophenolate mofetil was part of the anti-rejection regimen in 182 of 189 patients (98%), and the medication dose in 71% of these patients had to be reduced at some point because of intolerance or toxicity. The prevalence of sustained significant rejection was significantly higher in the group of patients with GI intolerance to MMF compared with patients maintained on target doses (66% vs 35%, p = 0.002) or patients with non-GI related toxicities necessitating dose reduction (67% vs 35%, p = 0.003). Gastrointestinal intolerance is a common reason ...Continue Reading

References

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Citations

Nov 26, 2010·Transplantation·Pamala A JacobsonUNKNOWN DeKAF investigators
Aug 21, 2009·Clinical Pharmacokinetics·Caroline Monchaud, Pierre Marquet
Aug 27, 2009·Clinical Pharmacokinetics·Caroline Monchaud, Pierre Marquet
May 6, 2014·Archives of Toxicology·Christine E Staatz, Susan E Tett
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Jan 25, 2011·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sieglinde KoflerIngo Kaczmarek
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Jan 12, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Erin L OhmannSteven A Webber
Jun 2, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Sieglinde KoflerIngo Kaczmarek
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Jul 14, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Kris OreschakChristina L Aquilante
Jul 29, 2021·Clinical Transplantation·Amit AlamTeena Sam

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