Mycophenolate monitoring in liver, thoracic, pancreas, and small bowel transplantation: A consensus report

Marcelo Cantarovich, Nigel W. Brown, Mary H.H. Ensom, Ashok Jain, Dirk R.J. Kuypers, Teun Van Gelder, J. Michael Tredger

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations

Abstract

Assessing the value of mycophenolic acid (MPA) monitoring outside renal transplantation is hindered by the absence of any trial comparing fixed-dose and concentration-controlled therapy. However, in liver and thoracic transplantation particularly, clinical trials, observational studies with comparison groups, and case series have described MPA efficacy, exposure/efficacy relationships, pharmacokinetic variability, and clinical outcomes relating to plasma MPA concentrations. On the basis of this evidence, this report identifies MPA as an immunosuppressant for which the combination of variable disposition, efficacy, and adverse effects contributes to interindividual differences seemingly in excess of those optimal for a fixed-dosage mycophenolate regimen. Combined with experiences of MPA monitoring in other transplant indications, the data have been rationalized to define circumstances in which measurement of MPA concentrations can contribute to improved management of mycophenolate therapy in nonrenal transplant recipients.

Original languageEnglish (US)
Pages (from-to)65-77
Number of pages13
JournalTransplantation Reviews
Volume25
Issue number2
DOIs
StatePublished - Apr 2011

All Science Journal Classification (ASJC) codes

  • Transplantation

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