Making kidney transplants last longer: Large UM study finds newer drug is better

Kidney transplant recipients may be able to keep their new organs longer using a drug that was originally designed to prevent only short-term rejection, a new study from the University of Michigan concludes.

A compound called mycophenolate mofetil, or MMF, was found to reduce the risk of losing the new kidney due to chronic, or long-term, kidney failure better than the conventionally used drug azathioprine (AZA). The effect was not just due to MMF's ability to reduce acute rejection responses. In fact, the new results show the relative risk of chronic kidney failure is 27 percent lower with MMF. Both MMF and AZA are used in conjunction with two other compounds as a "triple therapy" to help suppress the body's immune response to a transplanted organ.

The report, based on one of the largest-ever examinations of chronic transplant failure, is being presented May 15 at a joint meeting of the American Society of Transplantation and the American Society of Transplant Surgeons by Bruce Kaplan, M.D., an associate professor of nephrology and co-medical director of renal transplantation in the University of Michigan Health System.

"For those who have endured the pain of kidney failure, the suspense of waiting for a transplant, the ordeal of surgery, and the hurdle of avoiding acute rejection, the threat of chronic rejection and loss of the kidney within a few years still looms," says Kaplan. "Our results suggest that therapy that includes MMF may offer longer kidney and patient survival than AZA by reducing the risk of both acute and chronic failure."

The results, based on data from 66,774 patients who received a new kidney between 1988 and 1997 and whose kidneys survived the first six months after transplant, confirms an effect suggested by much smaller studies at other centers.

For the new report, Kaplan and his colleagues examined the four-year survival of both the kidneys and the patients, as recorded by the U.S. Scientific Renal Tra

Contact: Kara Gavin
University of Michigan Health System

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