Mycophenolate mofetil (MMF) in heart transplantation: rejection prevention and treatment.

摘要: Mycophenolate mofetil (MMF), the morpholinoethylester of mycophenolic acid, inhibits de novo pathway for purine synthesis. Evidence suggests that MMF suppresses lymphocyte function more than neutrophils, erythrocytes, and other rapidly dividing cell lines can utilize salvage pathways While rigorous efficacy data await completion an ongoing, multicenter, prospectively randomized, placebo-controlled trial, long-term safety are, however, available from numerous uncontrolled trials in cardiac transplantation. Dose-ranging 49 heart recipients suggest doses > or = 4000 mg/d are associated with significant, reversible gastrointestinal toxicity when compared 1000 may have fewer rejection episodes. Even long term, changing azathioprine to is increases hematocrit (p < 0.001), total WBC count 0.005), absolute neutrophil 0.005). Successful use refractory allograft advantage over azathioprine. safe appears be at least as effective immunosuppression following