Levels of mycophenolic acid and its glucuronide derivative in the plasma of liver, small bowel and kidney transplant patients receiving tacrolimus and cellcept combination therapy

Alexandra K. Tsaroucha*, Keith Zucker, Violet Esquenazi, Ludmilla De Faria, Joshua Miller, Andreas G. Tzakis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

In order to help assess the usefulness of mycophenolate mofetil (MMF) as an immunosuppressive agent in recipients of organs other than kidneys, we measured the trough levels of the active metabolite of MMF, mycophenolic acid (MPA), and its inactive glucuronide derivative (MPAG), in the plasma of liver (n = 83) and small bowel transplant patients (n = 15) receiving MMF in combination with tacrolimus. These levels were compared with a group of renal transplant patients (n = 25) receiving the same drug regimen. All patient groups were otherwise comparable except the small bowel patient group which contained more pediatric patients (average age 18.7 ± 3.9 years), and, therefore, received a higher average drug dose (in mg/kg). Despite this, these patients displayed the lowest levels of MPA of any group (0.39 ± 0.08 μg/ml, P < 0.001 vs. 1.10 ± 0.17 μg/ml for liver transplant patients, P < 0.001 or 2.46 ± 0.37 μg/ml for renal transplant patients, P < 0.001). There were no statistically significant differences in MPAG levels between any of the groups. Although preliminary, these data demonstrate significant transplanted organ-specific differences in MMF pharmacology and/or bioavailability, and suggest the need for separate evaluation of MMF dosing for each transplant type. (C) 2000 Elsevier Science B.V. All rights reserved.

Original languageEnglish (US)
Pages (from-to)143-146
Number of pages4
JournalTransplant Immunology
Volume8
Issue number2
DOIs
StatePublished - Sep 30 2000

Keywords

  • Immunosuppression
  • Kidney transplantation
  • Liver
  • Mycophenolate mofetil
  • Mycophenolic acid
  • Mycophenolic acid glucuronide derivative levels
  • Small bowel
  • Tacrolimus

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Transplantation

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