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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Successful rescue therapy with mycophenolate mofetil in kidney transplantation improves the long-term graft survival

1
Clinic of Surgery, Tartu University Hospital
2
Department of Nephrology, West-Tallinn Central Hospital, Estonia
*
Author to whom correspondence should be addressed.
Medicina 2007, 43(12), 953; https://doi.org/10.3390/medicina43120124
Received: 15 May 2007 / Accepted: 17 November 2007 / Published: 22 November 2007
Objective. The aim of this study was to compare the graft survival after kidney transplantation in patients treated with azathioprine (AZA) or mycophenolate mofetil (MMF) and analyze the significance of different risk factors for graft survival.
Material and methods
. A total of 137 patients, transplanted between January 1996 and June 2001, were retrospectively divided into two groups: patients who received AZA together with cyclosporine A and methylprednisolone (AZA group, n=72) and patients who received MMF either immediately or were switched from AZA to MMF during 3 months (MMF group, n=65).
Results. According to Kaplan-Meier analysis, a 1-year graft survival was 79% in the AZA group and 85% in the MMF group; a 6-year graft survival was 51% and 67%, respectively (P=0.046). Multivariate Cox survival model demonstrated that MMF therapy reduced the risk of graft loss by 34% (P=0.028), while delayed graft function increased the risk of graft loss (risk ratio 2.26, P=0.009). A statistically significant difference in total cholesterol level (6.7 vs. 5.7 mmol/L, respectively; P=0.002), mean systolic blood pressure (145 vs. 134 mmHg, P=0.009), and cyclosporine A daily dose (238 vs. 203 mg, P=0.015) between the AZA and MMF groups at 1 year was revealed.
Conclusion
. MMF rescue therapy improves the long-term graft survival compared to AZA despite high early rejection rate and avoids the negative impact of acute rejections on graft survival.
Keywords: kidney transplantation; graft survival; mycophenolate mofetil; azathioprine kidney transplantation; graft survival; mycophenolate mofetil; azathioprine
MDPI and ACS Style

Kahu, J.; Lõhmus, A.; Ilmoja, M.; Kirsimägi, Ü.; Timberg, G.; Peetsalu, A. Successful rescue therapy with mycophenolate mofetil in kidney transplantation improves the long-term graft survival. Medicina 2007, 43, 953.

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