Effect of mycophenolic acid and tacrolimus on the incidence of infectious complications after kidney transplantation
Matej Vnučák1, Karol Graňák1, Monika Beliančinová1, Ivana Dedinská1.
1Transplantation Center, University Hospital in Martin and Jessenius Medical Faculty of the Comenius University, Martin, Slovakia (Slovak Republic)
Introduction: Infectious complications remain a common cause of mortality after kidney transplantation (KTx). Goal of effective immunosuppressive treatment must be balanced between the decreasing incidence of acute kidney rejection (AKR) and at the same time avoiding the incidence of infections.
Materials and methods: The aim of our analysis was to identify the risk of fixed daily dose (DD) of mycophenolic acid (MPA) and levels of tacrolimus (TAC) in the development of a single, recurrent infection and AKR after KTx.
Results: Our analysis consisted of 100 patients after KTx (66 males, 34 females). MPA daily dose > 1080 mg was a risk factor (RF) for recurrent infection in general (OR 1.2964;P=0.0277), for recurrent bacterial infection from 1st-6th month (OR 1.2674;P=0.0151), recurrent bacterial infection (OR 1.2574;P=0.0436), single viral infection (OR 1.2640;P=0.0398) from 6th-12th month after KTx. Daily dose of MPA > 1080 mg and levels of TAC above recommended levels were not independent RF for the incidence of the infection.
Conclusion: Daily dose of MPA > 1080 mg as a RF for recurrent infection starting in the 1st month after KTx with significant association between the incidence of infections and MPA daily dose and TAC levels, without increased risk of AKR. In the centers with fixed dosing of immunosuppression, this can lead to lowering the risk of infections by decreasing daily dose of MPA 1 month after KTx without increasing risk of infections.
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