Lack of correlation between serum levels of mycophenolate mofetil and kidney transplant outcome in tacrolimus-based immunosupression

When used, mycophenolate mofetil (MMF) has been reported to prevent acute and chronic rejection in combination with CsA or tacrolimus (TAC) in kidney and in other organ transplantations. The current administration dosage is not standardized, ranging from 1 to 3 g/d, with high variability of serum levels, absence of correlation between MMF dose and trough serum concentrations of its metabolite, mycophenolic acid (MPA), and unpredictable occurrence of side effects. The ideal dosage to prevent rejection without increasing the risk of serious adverse events is defined only empirically, especially in the maintenance regimen, because of effects when added to CsA o tacrolimus. The aim of our study was to relate the clinical course of kidney transplant (KT) patients to serum levels of MPA.